| Doctor Name: | MR. ROGER KENNETH SMITH |
| NPI Number: | 1023395241 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MDIV |
| License Number: | |
| Business Practice Address: | 835 Houston Run Dr Gap, PA - 175279489 |
| Business Phone Number: | 7174429577 |
| Business Fax Number: | 7174429672 |
| Mailing Address: | 1068 Sunwood Ln, LANCASTER |
| State: | PA |
| Postal Code: | 176017118 |
| Phone Number: | 7173815785 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2011 |
| NPI Last Update Date: | 11/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |