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Individual

KYLIE NICHOLE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2599
(314) 989-8100
Mailing address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2599

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2019030412
MO
1041C0700X
Clinical Social Worker
CW020919
PA

Other

Enumeration date
01/29/2020
Last updated
09/08/2021
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