Individual
SHAYLA DANA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4220 GRAND AVE, ST LOUIS, MO 63107
(314) 534-6624
Mailing address
4220 N GRAND BLVD, SAINT LOUIS, MO 63107-1831
(312) 877-9494
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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