| Doctor Name: | DR. GARY WAYNE SMITH |
| NPI Number: | 1245244375 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | LPC004048 |
| Business Practice Address: | 804 N Wiley Ave Donalsonville, GA - 398451120 |
| Business Phone Number: | 2295248994 |
| Business Fax Number: | 2295241272 |
| Mailing Address: | 804 N Wiley Ave, DONALSONVILLE |
| State: | GA |
| Postal Code: | 398451120 |
| Phone Number: | 2295248994 |
| Fax Number: | 2295241272 |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 07/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC004048 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |