Individual
JACQUELINE MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
2616 ERWIN AVE, DUPONT, WA 98327-8758
(951) 966-9949
Mailing address
2616 ERWIN AVE, DUPONT, WA 98327
(951) 966-9949
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
05/13/2013
Last updated
05/13/2013
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