Individual
MICAH JOEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3801 JOHNSON MILL BLVD # AB, FAYETTEVILLE, AR 72704-5297
(479) 790-0684
Mailing address
327 S UNIVERSITY AVE APT 4, FAYETTEVILLE, AR 72701-5861
(479) 790-0684
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
200127
AR
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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