Individual
MARISSA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
6770 N STATE ROAD 39, LEBANON, IN 46052-8250
(574) 242-1294
Mailing address
6770 N STATE ROAD 39, LEBANON, IN 46052-8250
(574) 242-1294
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
99088059A
IN
Other
Enumeration date
08/09/2018
Last updated
05/29/2025
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