Individual
KAITLYN VICTORIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
60 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1822
(479) 695-1240
Mailing address
60 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1822
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
10167
AR
Other
Enumeration date
11/03/2020
Last updated
09/11/2023
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