Doctor Name: | MS. SUZETTE M SMITH |
NPI Number: | 1003911025 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 9170 |
Business Practice Address: | 1103 Fortune Ave Panama City, FL - 324011831 |
Business Phone Number: | 8507696188 |
Business Fax Number: | 8507691261 |
Mailing Address: | 111 Edgartown Rd, VINEYARD HAVEN |
State: | MA |
Postal Code: | 025685699 |
Phone Number: | 5086937900 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2006 |
NPI Last Update Date: | 11/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 9170 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |