Organization Name: | MICHELLE L. SMITH, MA, LPC |
NPI Number: | 1003244401 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHELLE L SMITH (OWNER) |
Mailing Address: | 15200 Moonlight Trl Conroe |
State: | TX US |
Postal Code: | 773843540 |
Phone Number: | 9366486724 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2013 |
NPI Last Update Date: | 10/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 63615 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |