Individual
MISS SARA NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1603 CAPITOL AVE, SUITE 510, CHEYENNE, WY 82001-4569
(307) 635-2888
(307) 635-2888
Mailing address
1808 CROOK AVE, CHEYENNE, WY 82001-5326
(307) 757-7208
(307) 635-2888
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
132080700
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132080700
—
WY
Enumeration date
01/03/2013
Last updated
01/03/2013
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