Individual
MRS. LESLIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1906 S LANCASTER AVE, SPRINGFIELD, MO 65807-2429
(417) 459-7247
Mailing address
1906 S LANCASTER AVE, SPRINGFIELD, MO 65807-2429
(417) 459-7247
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2014009397
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154731958
—
MO
Enumeration date
05/01/2014
Last updated
01/04/2017
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