Individual
MARISA J. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
9717 WALTHORNE CT, BURKE, VA 22015-4044
(703) 323-7301
Mailing address
9717 WALTHORNE CT, BURKE, VA 22015-4044
(703) 323-7301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
05/22/2007
Last updated
05/08/2013
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