Individual
MRS. REGINA CHANELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2846 ALCOTT LN, GRAND PRAIRIE, TX 75052-8345
(972) 606-4908
Mailing address
2580 W CAMP WISDOM RD, SUITE, 100 - #137, GRAND PRAIRIE, TX 75052-3088
(972) 606-4908
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
578436
TX
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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