Individual
LA RUE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1033 LARCHWOOD RD, MANSFIELD, OH 44907-2424
(419) 747-4122
Mailing address
404 LEE LN, MANSFIELD, OH 44905-2722
(419) 961-9974
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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