Individual
WAKESHA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1445 SAMUEL ST APT 232, CHARLOTTE, NC 28206-1568
(323) 496-6813
Mailing address
1445 SAMUEL ST APT 232, CHARLOTTE, NC 28206-1568
(323) 496-6813
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
21364677
NC
Other
Enumeration date
09/16/2022
Last updated
09/16/2022
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