Individual
MS. STACEY C SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4166 LINDELL BLVD STE 1B, SAINT LOUIS, MO 63108-2923
(314) 484-7758
Mailing address
4166 LINDELL BLVD STE 1B, SAINT LOUIS, MO 63108-2923
(314) 484-7758
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073099404
—
MO
Enumeration date
09/23/2019
Last updated
11/27/2023
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