| NPI | 1225735194 |
|---|---|
| Former Name | JESSICA LENORE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KY 3019012) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-02-13 |