Individual
ALEXIS KEANNA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1033 LARCHWOOD RD, MANSFIELD, OH 44907-2424
(419) 747-4122
(419) 747-4126
Mailing address
14 OTTAWA AVE # A, FREDERICKTOWN, OH 43019-9037
(740) 501-0237
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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