| Doctor Name: | KELLI L SMART |
| NPI Number: | 1184769820 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYCHOLOGIST |
| License Number: | |
| Business Practice Address: | 8766 East Hwy 69 Humboldt Unified School District #22 Special Service Prescott Valley, AZ - 86314 |
| Business Phone Number: | 9287594028 |
| Business Fax Number: | 9287594030 |
| Mailing Address: | 1196 Buena Vista W, DEWEY |
| State: | AZ |
| Postal Code: | 86327 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/20/2007 |
| NPI Last Update Date: | 07/26/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |