Individual
MS. AUTUMN LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9909 E 100 S, GREENTOWN, IN 46936-9163
(765) 628-0605
(765) 628-3639
Mailing address
6944 LILAC RD, PLYMOUTH, IN 46563-9504
(574) 952-5273
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IN
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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