| Doctor Name: | MS. MELISSA ANNE SMITH |
| NPI Number: | 1114373818 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., L.A.C. |
| License Number: | 37AC00291700 |
| Business Practice Address: | 23 S Kinderkamack Rd Montvale, NJ - 076452128 |
| Business Phone Number: | 2019823846 |
| Business Fax Number: | |
| Mailing Address: | 23 S Kinderkamack Rd, MONTVALE |
| State: | NJ |
| Postal Code: | 076452128 |
| Phone Number: | 2019823846 |
| Fax Number: | |
| NPI Enumeration Date: | 05/11/2016 |
| NPI Last Update Date: | 05/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 37AC00291700 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |