Doctor Name: | MS. JO ANN SMITH |
NPI Number: | 1104832153 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., LPC |
License Number: | P9408023 |
Business Practice Address: | 3111 South 70th Street Van Buren, AR - 729561944 |
Business Phone Number: | 4794445048 |
Business Fax Number: | 4794445039 |
Mailing Address: | 106 Azure Hills Dr, VAN BUREN |
State: | AR |
Postal Code: | 729562214 |
Phone Number: | 4794223119 |
Fax Number: | 4794525847 |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 02/12/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | P9408023 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |