Provider Demographics
NPI:1316538127
Name:SMITH, PATIENCE NICOLE (COTA/L)
Entity type:Individual
Prefix:
First Name:PATIENCE
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1352
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28771-1352
Mailing Address - Country:US
Mailing Address - Phone:828-735-3712
Mailing Address - Fax:
Practice Address - Street 1:1422 DICK BRANCH RD
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28771-7943
Practice Address - Country:US
Practice Address - Phone:828-735-3712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13848224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant