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Individual

KANIYA KASHELL SMOTHERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3834A COTEBRILLIANTE AVE., ST LOUIS , MO, MO 63113
(314) 489-8686
Mailing address
721 SCIECEHILL DR., ST.LOUIS, MO 63137
(314) 489-8686

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary

Other

Enumeration date
10/01/2018
Last updated
10/01/2018
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