Individual
MR. DEQUAN LAMAR SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BT
Contact information
Practice address
800 OAK ST, FARMVILLE, VA 23901-1199
(434) 201-8250
Mailing address
3737 SCOTTS CROSSROADS, CHASE CITY, VA 23924-3336
(434) 210-8250
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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