| NPI | 1023566296 |
|---|---|
| Former Name | SHANDRA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851110118) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801110118) |
| 247200000X Technician, Other | |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2021-07-21 |