Doctor Name: | JOSHUA SMITH |
NPI Number: | 1104274257 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | NLC.0105012 |
Business Practice Address: | 1158 N Burlington Dr Castle Rock, CO - 801048706 |
Business Phone Number: | 3036683192 |
Business Fax Number: | |
Mailing Address: | 1158 N Burlington Dr, CASTLE ROCK |
State: | CO |
Postal Code: | 801048706 |
Phone Number: | 3036683192 |
Fax Number: | |
NPI Enumeration Date: | 05/31/2016 |
NPI Last Update Date: | 05/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | NLC.0105012 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |