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Individual

BRIENNE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
733 N FLAG CHAPEL RD, JACKSON, MS 39209-2206
(601) 922-5530
Mailing address
733 N FLAG CHAPEL RD, JACKSON, MS 39209-2206
(601) 922-5530

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A2942
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A2942
MS STATE BOARD OF HEALTH
MS
Enumeration date
02/26/2008
Last updated
02/26/2008
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