Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174V00000X | Clinical Ethicist |
NPI | 1134410467 |
---|---|
Provider Name | Mrs. Dalisha Lareece Smith |
First Address | Jonesboro, AR 72404 |
Second Address | Trumann, AR 72472 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2011 |
Last Update Date | 21/03/2014 |