Individual
SOPHIA COLLINS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
23300 PROVIDENCE DR, APT 818, SOUTHFIELD, MI 48075-3652
(248) 242-0522
Mailing address
23300 PROVIDENCE DR, APT 818, SOUTHFIELD, MI 48075-3652
(248) 242-0522
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111821
MI
Other
Enumeration date
05/07/2017
Last updated
05/07/2017
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