Provider Information for 1942527791
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Mrs. STEPHANIE SMITH LCSW
Sex: Female
NPI: 1942527791
Last Updated: 2010-05-03
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1942527791 | ||||||||
| Enumeration Date | 2010-05-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 118 COLLEGE DR PO BOX 5114 HATTIESBURG, MS 39406-0002 United States Phone: 601-266-4294 | Fax:601-266-4167 | ||||||||
| Primary Practice Address | 118 COLLEGE DR HATTIESBURG, MS 39406-0002 United States Phone: 601-266-4294 | Fax:601-266-4167 | ||||||||
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