Individual
CASSANDRA GRACE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1936 RUSS DEBERRY RD, TERRA ALTA, WV 26764-6663
(304) 435-7059
Mailing address
1936 RUSS DEBERRY RD, TERRA ALTA, WV 26764-6663
(304) 435-7059
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
A9R138399116
WV
Other
Enumeration date
06/26/2025
Last updated
06/26/2025
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