Doctor Name: | VICKY KATE SMITH |
NPI Number: | 1427248582 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2007021192 |
Business Practice Address: | 380 E State Highway Cc Ste. A-105 Nixa, MO - 657147337 |
Business Phone Number: | 4177258810 |
Business Fax Number: | 4177256206 |
Mailing Address: | 380 E State Highway Cc, Ste. A-105 NIXA |
State: | MO |
Postal Code: | 657147337 |
Phone Number: | 4177258810 |
Fax Number: | 4177256206 |
NPI Enumeration Date: | 07/25/2007 |
NPI Last Update Date: | 07/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2007021192 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |