Individual
BETH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
825 CUGEL FARM LN, GENEVA, OH 44041-7773
(440) 645-5711
Mailing address
825 CUGEL FARM LN, GENEVA, OH 44041-7773
(440) 645-5711
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0402417
—
OH
Enumeration date
09/18/2020
Last updated
09/18/2020
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