Individual
MARISSA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
55 W 39TH ST RM 708, NEW YORK, NY 10018-0561
(951) 990-9437
Mailing address
620 W 143RD ST APT 5G, NEW YORK, NY 10031-5953
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006046-1
NY
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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