Individual
LAWONA S SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
112 WYNN ST, PORTSMOUTH, VA 23701-3140
(757) 438-5323
Mailing address
112 WYNN ST, PORTSMOUTH, VA 23701-3140
(757) 438-5323
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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