Individual
JACKSON ALYCE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 SE 25TH ST, TOPEKA, KS 66605-1734
(785) 783-3274
Mailing address
236 S PATTIE AVE, WICHITA, KS 67211-1719
(316) 400-6863
(620) 322-0272
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01143T
KS
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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