Individual
TERESA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26184 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7500
Mailing address
26184 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7516
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704323445
MI
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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