Individual
MRS. CRYSTAL G SMIDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
286 HATFIELD ST, JELLICO, TN 37762-2616
(606) 280-5955
Mailing address
286 HATFIELD ST, JELLICO, TN 37762-2616
(606) 280-5955
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/18/2010
Last updated
05/20/2019
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