Individual
MANVI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2555 MARVIN RD NE, PMG SW WA HAWKS PRAIRIE FM, LACEY, WA 98516-3138
(360) 413-4200
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60123137
WA
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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