Individual
STEPHANIE NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
24815 TRICKUM RD, HOUSTONIA, MO 65333-2221
(660) 229-0413
Mailing address
24815 TRICKUM RD, HOUSTONIA, MO 65333-2221
(660) 229-0413
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-319091
MO
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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