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Individual

MS. INGRID J.M SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.C.S.W

Contact information

Practice address
5540 CATES AVE, SAINT LOUIS, MO 63112-3008
(314) 724-5804
Mailing address
PO BOX 300453, SAINT LOUIS, MO 63130-0622
(314) 724-5804

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
149021043
IL
1041C0700X
Clinical Social Worker
Primary
20017008851
MO

Other

Enumeration date
06/26/2014
Last updated
06/18/2019
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