Doctor Name: | MS. DEBORRA MARIE SMITH |
NPI Number: | 1093883431 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW |
License Number: | 00732 |
Business Practice Address: | 1307 Sunnyside Ln Atlantic, IA - 500222205 |
Business Phone Number: | 7122431213 |
Business Fax Number: | 7122434675 |
Mailing Address: | 140 1800th St, P.o. Box #1 PANAMA |
State: | IA |
Postal Code: | 515626104 |
Phone Number: | 7124892824 |
Fax Number: | 7122434675 |
NPI Enumeration Date: | 12/02/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 00732 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |