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Individual

MS. LAURIE J. SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
380 MAPLE AVE W, SUITE 303 B, VIENNA, VA 22180-5620
(703) 938-2949
Mailing address
380 MAPLE AVE W, SUITE 303 B, VIENNA, VA 22180-5620
(703) 938-2949

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
08030000228
VA

Other

Enumeration date
09/21/2007
Last updated
09/21/2007
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