| Doctor Name: | PORTIA SMITH |
| NPI Number: | 1376966374 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, CRC |
| License Number: | LPC007434 |
| Business Practice Address: | 508 Covington Cv Byron, GA - 310089525 |
| Business Phone Number: | 4789526703 |
| Business Fax Number: | |
| Mailing Address: | 508 Covington Cv, BYRON |
| State: | GA |
| Postal Code: | 310089525 |
| Phone Number: | 4789526703 |
| Fax Number: | |
| NPI Enumeration Date: | 01/27/2014 |
| NPI Last Update Date: | 01/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC007434 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |