Individual
MISS JILL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.PED
Contact information
Practice address
1235 EAST BLVD, SUITE K, CHARLOTTE, NC 28203
(704) 335-4070
Mailing address
1235 EAST BLVD, SUITE K, CHARLOTTE, NC 28203-5876
(704) 335-4070
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
CPED3467
NC
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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