| Doctor Name: | JODIE SMITH |
| NPI Number: | 1316325533 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LLPC |
| License Number: | |
| Business Practice Address: | 10204 Corcoran Rd Haslett, MI - 488409226 |
| Business Phone Number: | 5174165131 |
| Business Fax Number: | |
| Mailing Address: | Po Box 448, HASLETT |
| State: | MI |
| Postal Code: | 488400448 |
| Phone Number: | 5174165131 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2015 |
| NPI Last Update Date: | 04/19/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |