Individual
CHAMPAGNAE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 EVANS MILL DR, DALLAS, GA 30157-1622
(215) 475-1327
Mailing address
8802 VALENCIA ROSE, DOUGLASVILLE, GA 30134-1675
(215) 475-1327
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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