| NPI | 1013177872 |
|---|---|
| Former Name | STEPHANIE COLLEEN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 14922) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 85523-20) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 1252071) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2025-03-28 |