Individual
ELISSA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4241 SUMMIT CORNER DR APT 138, FAIRFAX, VA 22030-8419
(703) 338-2762
Mailing address
4241 SUMMIT CORNER DR APT 138, FAIRFAX, VA 22030-8419
(703) 338-2762
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/30/2022
Last updated
01/30/2022
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