Individual
MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6394 COLLEGE BLVD, LEAWOOD, KS 66211-1506
(913) 392-8911
Mailing address
6394 COLLEGE BLVD, LEAWOOD, KS 66211-1506
(913) 392-8911
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-215469
KS
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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