Individual
MS. NANCY ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSE, LP
Contact information
Practice address
1333 MAY ST., WABASSO, MN 56293
(507) 342-7118
Mailing address
1013 CEDAR ST, WABASSO, MN 56293-1409
(507) 342-2030
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
323282
MN
103T00000X
Psychologist
LP4126
MN
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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