Individual
KIA AYANA GLIMPS-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4085 HANCOCK BRIDGE PKWY STE 101, NORTH FORT MYERS, FL 33903-7220
(239) 677-3767
Mailing address
175 MIDDLE ST UNIT 1201, LAKE MARY, FL 32746-3625
(866) 610-0580
(866) 610-0580
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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