| Doctor Name: | DR. THOMAS EDWIN SMITH |
| NPI Number: | 1164638987 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 34002582A |
| Business Practice Address: | 2955 W Orland Rd Angola, IN - 467038043 |
| Business Phone Number: | 2608334976 |
| Business Fax Number: | 2608331885 |
| Mailing Address: | 2955 W Orland Rd, ANGOLA |
| State: | IN |
| Postal Code: | 467038043 |
| Phone Number: | 2608334976 |
| Fax Number: | 2608331885 |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34002582A |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |