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Individual

MARISSA LEIGH SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
408 W 6TH ST, LARNED, KS 67550-3027
(620) 804-2383
Mailing address
6214 24TH AVE, BROOKLYN, NY 11204-3319

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
04/28/2023
Last updated
04/28/2023
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