Individual
GINA M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 W MOHAWK LN, PHOENIX, AZ 85027-5946
(623) 445-3700
Mailing address
20402 N 15TH AVE, PHOENIX, AZ 85027-3699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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