| Doctor Name: | MS. GRETCHEN DETERS-SMITH |
| NPI Number: | 1316096183 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMFT |
| License Number: | MT0000929 |
| Business Practice Address: | 346 Magnolia St Atlantic Beach, FL - 322334028 |
| Business Phone Number: | 9042471117 |
| Business Fax Number: | 9042420105 |
| Mailing Address: | 346 Magnolia St, ATLANTIC BEACH |
| State: | FL |
| Postal Code: | 322334028 |
| Phone Number: | 9042471117 |
| Fax Number: | 9042420105 |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 12/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MT0000929 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |