Doctor Name: | MRS. LORICE GRADY SMITH |
NPI Number: | 1073660643 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LIP/LPC-A/LCAS-A/LRT |
License Number: | 3031-A |
Business Practice Address: | 305 Hunters Creek Dr Goldsboro, NC - 275348329 |
Business Phone Number: | 9199209976 |
Business Fax Number: | |
Mailing Address: | 305 Hunters Creek Dr, GOLDSBORO |
State: | NC |
Postal Code: | 275348329 |
Phone Number: | 9199889582 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2007 |
NPI Last Update Date: | 04/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 3031-A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |