Smith, Jacqueline

Smith, Jacqueline is an individual health care provider with primary practice located at 120 Hospital Rd Suite 100, Prince Frederick MD 20678-4022. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Smith, Jacqueline can be contacted via phone (410) 414-4846.

Contact Information

Primary practice address
120 Hospital Rd Suite 100 Prince Frederick MD 20678-4022
Phone: (410) 414-4846
Fax: (410) 414-4810
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 04457 Maryland

Profile Details

NPI number 1265500300
LBN Legal business name Smith, Jacqueline
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2006
Last updated Jun 25th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265500300 NPPES
Maryland Other 606MH211 MECICARE PROVIDER ID
Maryland MEDICAID 770428300 MECICARE PROVIDER ID

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