Provider Demographics
NPI:1871739664
Name:SMITH, ANITA LOUISE (OT/L)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:LOUISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MARSH HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28570-5567
Mailing Address - Country:US
Mailing Address - Phone:252-354-7452
Mailing Address - Fax:
Practice Address - Street 1:132 MARSH HARBOUR DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NC
Practice Address - Zip Code:28570-5567
Practice Address - Country:US
Practice Address - Phone:252-354-7452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-28
Last Update Date:2008-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics