Individual
STACIE MIRIAM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3 WOEWASSA LN, FARMINGTON, CT 06032-1038
(860) 459-6300
Mailing address
3 WOEWASSA LN, FARMINGTON, CT 06032-1038
(860) 459-6300
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
09/25/2019
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