Doctor Name: | MERIDETH SMITH |
NPI Number: | 1538554050 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 1099 |
Business Practice Address: | 1 Mountainside Way Mount Olive, WV - 251850001 |
Business Phone Number: | 3044427213 |
Business Fax Number: | |
Mailing Address: | Po Box 9569, SOUTH CHARLESTON |
State: | WV |
Postal Code: | 253090569 |
Phone Number: | 3043448515 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2015 |
NPI Last Update Date: | 04/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1099 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |