Individual
STEPHANIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3235 ACADEMY AVE STE 303, PORTSMOUTH, VA 23703-3200
(757) 454-2112
(855) 938-3318
Mailing address
PO BOX 7693, PORTSMOUTH, VA 23707-0693
(757) 454-2112
(855) 938-3318
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0704011447
VA
Other
Enumeration date
02/16/2021
Last updated
02/16/2021
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