| Doctor Name: | MRS. KRISTIE NICOLE SMITH |
| NPI Number: | 1336411586 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P.C. |
| License Number: | 4793 |
| Business Practice Address: | 1310 N Hearne Ave Shreveport, LA - 711076516 |
| Business Phone Number: | 3186765111 |
| Business Fax Number: | 3186765137 |
| Mailing Address: | 1310 N Hearne Ave, SHREVEPORT |
| State: | LA |
| Postal Code: | 711076516 |
| Phone Number: | 3186765111 |
| Fax Number: | 3186765137 |
| NPI Enumeration Date: | 02/03/2012 |
| NPI Last Update Date: | 09/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 4793 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |