Individual
LAUREN KATHLEEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9039 W BROAD ST STE 1, HENRICO, VA 23294-5842
(804) 562-0814
Mailing address
9039 W BROAD ST STE 1, HENRICO, VA 23294-5842
(804) 562-0814
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
158210966793
VA
Other
Enumeration date
09/18/2024
Last updated
09/18/2024
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