| NPI | 1134559610 |
|---|---|
| Former Name | STEPHANIE L SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 2759) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN R1908376) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2024-01-24 |