Individual
CHANTIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
910 S VIENNA ST STE 7, RUSTON, LA 71270-5864
(318) 224-9200
(318) 224-9201
Mailing address
170 OLIVE ST, RUSTON, LA 71270-1285
(318) 550-6743
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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