Individual
MRS. LAVEL IRENE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 S CLARWIN AVE, GLADWIN, MI 48624-9401
(989) 429-3272
Mailing address
311 S CLARWIN AVE, GLADWIN, MI 48624-9401
(989) 429-3272
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
AF260002059
MI
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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