Individual
LYDIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 HICKORY ST, THIBODAUX, LA 70301-2011
(985) 446-2936
(985) 446-2940
Mailing address
303 HICKORY ST, THIBODAUX, LA 70301-2011
(985) 446-2936
(985) 446-2940
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
298012
LA
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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