Individual
MRS. JESSICA MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 FULLER ST, ALEXANDRIA BAY, NY 13607-1391
(315) 482-2511
Mailing address
405 MILL ST, THERESA, NY 13691-2229
(580) 222-4680
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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