| Doctor Name: | MRS. THERESA MARIA SMITH |
| NPI Number: | 1053449827 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW |
| License Number: | I. 0004342 |
| Business Practice Address: | 202 E Bagley Rd Berea, OH - 440172058 |
| Business Phone Number: | 4402608303 |
| Business Fax Number: | |
| Mailing Address: | 32066 Handford Blvd, AVON LAKE |
| State: | OH |
| Postal Code: | 440122936 |
| Phone Number: | 4409333123 |
| Fax Number: | |
| NPI Enumeration Date: | 03/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I. 0004342 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |