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Individual

JASEE S SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
615 S DIVISION ST STE A, MOSES LAKE, WA 98837-3800
(509) 764-6644
(509) 764-6676
Mailing address
1125 S EASTLAKE DR, MOSES LAKE, WA 98837-2113
(509) 770-1107

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
08/24/2020
Last updated
08/24/2020
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