| Doctor Name: | CHARLES R SMITH |
| NPI Number: | 1053538975 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.P.C. |
| License Number: | |
| Business Practice Address: | 4539 S 1800 W Apt 109 Roy, UT - 840673629 |
| Business Phone Number: | 8018653337 |
| Business Fax Number: | |
| Mailing Address: | 4539 S 1800 W Apt 109, ROY |
| State: | UT |
| Postal Code: | 840673629 |
| Phone Number: | 8018653337 |
| Fax Number: | |
| NPI Enumeration Date: | 04/20/2007 |
| NPI Last Update Date: | 05/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |