Individual
MIRANDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
GSW
Contact information
Practice address
11990 JACKSON ST, CLINTON, LA 70722-0395
(225) 683-5292
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9329
LA
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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