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Individual

MRS. LISA L SMOOTS-LEVY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OWNER

Contact information

Practice address
405 BRIARWOOD DR STE 103H, JACKSON, MS 39206-3029
(601) 454-0958
Mailing address
405 BRIARWOOD DR STE 103H, JACKSON, MS 39206-3029
(601) 940-5984

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
MS

Other

Enumeration date
12/05/2019
Last updated
03/27/2020
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