Individual
MS. KATIE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
0000000000000
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417099417
—
MI
Enumeration date
02/01/2023
Last updated
02/01/2023
Update your record
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