Individual
JACKIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4429 S RIVER BLVD STE B, INDEPENDENCE, MO 64055-4659
(816) 768-0090
(816) 912-1739
Mailing address
4429 S RIVER BLVD STE B, INDEPENDENCE, MO 64055-4659
(816) 768-0090
(816) 912-1739
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2018029056
MO
Other
Enumeration date
09/13/2024
Last updated
09/13/2024
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