Individual
DR. JAYME VIRGINIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
812 N HIGHWAY 5, MANSFIELD, MO 65704-7301
(417) 924-2059
Mailing address
PO BOX 677, MANSFIELD, MO 65704-0677
(417) 924-2059
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2007033886
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497540005
—
MO
Enumeration date
11/06/2007
Last updated
05/29/2008
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