Individual
SONYA MAE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
9471 W BRASS CIR, WASILLA, AK 99623-9202
(907) 203-0345
Mailing address
PO BOX 871448, WASILLA, AK 99687-1448
(907) 203-0345
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
111920
AK
225700000X
Massage Therapist
MA60293148
WA
Other
Enumeration date
06/20/2012
Last updated
05/22/2018
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