Doctor Name: | DENISE SMITH |
NPI Number: | 1396895439 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | M-06302 |
Business Practice Address: | 1500 N Mesa Rd Belen, NM - 870028528 |
Business Phone Number: | 5058649113 |
Business Fax Number: | 5058613681 |
Mailing Address: | Po Box 518, LOS LUNAS |
State: | NM |
Postal Code: | 870310518 |
Phone Number: | 5058653350 |
Fax Number: | 5058654739 |
NPI Enumeration Date: | 01/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | M-06302 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |