Individual
DEBORAH B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
57 INDUSTRIAL PARK RD, LUCEDALE, MS 39452
(601) 947-4274
(601) 947-4275
Mailing address
3407 SHAMROCK COURT, GAUTIER, MS 39553
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
10/23/2006
Last updated
07/27/2015
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