Individual
MIKEALA TIARA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
4475 REGENCY PL, SUITE 205, WHITE PLAINS, MD 20695-3072
(240) 427-3554
Mailing address
4475 REGENCY PL, SUITE 205, WHITE PLAINS, MD 20695-3072
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
19061
MD
Other
Enumeration date
07/02/2013
Last updated
07/02/2013
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