Individual
SARA JO SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCP
Contact information
Practice address
1344 N TAYLOR ST, EL DORADO, KS 67042-3860
(620) 203-9077
Mailing address
1344 N TAYLOR ST, EL DORADO, KS 67042-3860
(620) 203-9077
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01521
KS
Other
Enumeration date
11/11/2020
Last updated
11/20/2022
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