Individual
BIANCA I SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 N GROESBECK HWY, MOUNT CLEMENS, MI 48043-1562
(586) 914-2160
Mailing address
175 N GROESBECK HWY, MOUNT CLEMENS, MI 48043-1562
(586) 914-2160
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/12/2018
Last updated
02/04/2021
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