Individual
MRS. KIZZIE MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1444 N HURON ST, TOLEDO, OH 43604-2014
(419) 917-8116
Mailing address
1444 N HURON ST, TOLEDO, OH 43604
(419) 917-8116
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
400218040303
OH
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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