Individual
STEPHANIE LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, IBCLC
Contact information
Practice address
4375 FAIR LAKES CT, FAIRFAX, VA 22033-4234
(571) 432-2669
Mailing address
4375 FAIR LAKES CT, FAIRFAX, VA 22033-4234
(571) 432-2669
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1031447
—
Other
Enumeration date
02/11/2019
Last updated
10/07/2020
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