Provider Demographics
NPI:1124254339
Name:SMITH, EMILY ELIZABETH (MS OTR/L)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
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Mailing Address - Street 1:402 POPLAR GROVE PL
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2768
Mailing Address - Country:US
Mailing Address - Phone:443-752-1617
Mailing Address - Fax:410-727-1617
Practice Address - Street 1:138 INDUSTRY LN
Practice Address - Street 2:UNIT 5A
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-1741
Practice Address - Country:US
Practice Address - Phone:443-752-1617
Practice Address - Fax:410-727-1617
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist