Individual
MELANIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1137 W 30TH ST, JACKSONVILLE, FL 32209-4019
(904) 413-2046
Mailing address
1137 W 30TH ST, JACKSONVILLE, FL 32209-4019
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
FL
Other
Enumeration date
07/07/2019
Last updated
07/07/2019
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