Doctor Name: | JODY SMETAK |
NPI Number: | 1093046708 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LMHC |
License Number: | |
Business Practice Address: | 116 Lee St Se Ste C Tumwater, WA - 985016721 |
Business Phone Number: | 3609701393 |
Business Fax Number: | 3607538981 |
Mailing Address: | 116 Lee St Se, Ste C TUMWATER |
State: | WA |
Postal Code: | 985016721 |
Phone Number: | 3609701393 |
Fax Number: | 3607538981 |
NPI Enumeration Date: | 01/19/2010 |
NPI Last Update Date: | 05/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |