Individual
KEIQUANAE TATAYANA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
55 SERGEANT PRENTISS DR STE 102, NATCHEZ, MS 39120-4791
(601) 304-5567
(601) 304-5697
Mailing address
55 SERGEANT PRENTISS DR STE 102, NATCHEZ, MS 39120-4791
(601) 304-5567
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/23/2019
Last updated
02/23/2019
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