| Doctor Name: | MISS SARA SMITH |
| NPI Number: | 1063591246 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CAC |
| License Number: | |
| Business Practice Address: | 691 S Oak St Seneca, SC - 296783827 |
| Business Phone Number: | 8648827563 |
| Business Fax Number: | 8648827388 |
| Mailing Address: | 106 Canterbury Rd, PENDLETON |
| State: | SC |
| Postal Code: | 296709403 |
| Phone Number: | 8649400305 |
| Fax Number: | |
| NPI Enumeration Date: | 11/06/2006 |
| NPI Last Update Date: | 02/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |