| NPI | 1740631589 |
|---|---|
| Former Name | MIKKI LACHELLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2020-01-15 |