Doctor Name: | DAVID SMITH |
NPI Number: | 1003066234 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | |
Business Practice Address: | 1904 W. Royale Drive Muncie, IN - 473042264 |
Business Phone Number: | 7652840043 |
Business Fax Number: | 7652844112 |
Mailing Address: | 1904 W. Royale Drive, MUNCIE |
State: | IN |
Postal Code: | 473042264 |
Phone Number: | 7652840043 |
Fax Number: | 7652844112 |
NPI Enumeration Date: | 09/24/2008 |
NPI Last Update Date: | 04/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |