Individual
DEBRA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
712 E 16TH ST, SAN BERNARDINO, CA 92404-5124
(909) 361-8720
Mailing address
696 E 16TH ST, SAN BERNARDINO, CA 92404-5108
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/01/2022
Last updated
09/01/2022
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