| NPI | 1043510746 |
|---|---|
| Former Name | STEPHANIE LYNN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2005038070) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MO 2011010083) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2023-03-03 |