Individual
IRIS SUSAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-6761
(727) 767-4715
Mailing address
11130 LOST CREEK TER, APT 203, LAKEWOOD RANCH, FL 34211-9353
(941) 465-5904
(727) 767-4715
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
03/02/2007
Last updated
10/14/2015
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