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Individual

SUSANNA OLEY SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
190 S MAIN ST STE B, CENTERVILLE, UT 84014-2839
(801) 614-8400
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 614-8400

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11850822-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN58293
DC

Other

Enumeration date
01/26/2017
Last updated
01/27/2026
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