Doctor Name: | DR. LAURENCE C. SMITH |
NPI Number: | 1023191491 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 2001 |
Business Practice Address: | 140 Sw 2nd St Cedaredge, CO - 814138902 |
Business Phone Number: | 9708564955 |
Business Fax Number: | 9708564359 |
Mailing Address: | 740 N Grand Mesa Dr, CEDAREDGE |
State: | CO |
Postal Code: | 814133007 |
Phone Number: | 9708564955 |
Fax Number: | 9708564359 |
NPI Enumeration Date: | 10/21/2006 |
NPI Last Update Date: | 03/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 2001 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |