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Individual

MRS. CONNIE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
13093 STATE ROUTE 7, LISBON, OH 44432-9559
(330) 385-6831
Mailing address
2707 LISBON ST, EAST LIVERPOOL, OH 43920-4053
(330) 383-0596

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP3708
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SP3708
OH
Enumeration date
02/21/2014
Last updated
02/21/2014
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