Individual
TRACEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 PHEASANT DR, LEBANON, PA 17046-8092
(717) 580-6049
Mailing address
13 PHEASANT DR, LEBANON, PA 17046-8092
(717) 580-6049
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW126502
PA
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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