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Individual

KAYLA ANN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MEDICAID PROVIDER

Contact information

Practice address
399 MEACHAM RD, RAY, OH 45672-9610
(740) 286-7120
Mailing address
399 MEACHAM RD, RAY, OH 45672-9610
(740) 286-7120

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0150979
OH
Enumeration date
12/01/2021
Last updated
12/01/2021
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