Most Relevant Information
Provider Data
| NPI Number: | 1003458621 |
| Provider Name: | TAMARA D SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 222Q00000X |
| Specialty: | Developmental Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/15/2019 |
| Last Updated: | 10/15/2019 |
Provider Practice Location
202 OAK ST
ADVANCE
IN
46102
Practice Location Phone/Fax
| Phone: | 7655861576 |
| Fax: |
Provider Mailing Location
PO BOX 246
ADVANCE
IN
461020246
Provider Mailing Phone/Fax
| Phone: | 7655861576 |
| Fax: |