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Individual

DEZSARAI SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-2102
(762) 408-2604
Mailing address
6600 VAN AALST BLVD, FORT BENNING, GA 31905-2102
(706) 561-7383

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
02/11/2009
Last updated
11/05/2025
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