Individual
SANDRA DALE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
523 DIXIE ST STE 1, CARROLLTON, GA 30117-3870
(770) 456-3266
Mailing address
322 NORTHLAKE DR, WARNER ROBINS, GA 31093-1646
(478) 952-7901
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/02/2021
Last updated
11/28/2023
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