Individual
JESSICA FAYE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
172 OXFORD CT, ATHENS, GA 30606-5091
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APC006693
GA
Other
Enumeration date
10/19/2018
Last updated
10/19/2018
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