| Doctor Name: | PETER SMITH |
| NPI Number: | 1568695500 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.ED., LCDC |
| License Number: | 9265 |
| Business Practice Address: | 896 Robin Ranch Rd Lockhart, TX - 786444578 |
| Business Phone Number: | 5123762101 |
| Business Fax Number: | 5123985696 |
| Mailing Address: | Po Box 577, LOCKHART |
| State: | TX |
| Postal Code: | 786440577 |
| Phone Number: | 5123762101 |
| Fax Number: | 5123985696 |
| NPI Enumeration Date: | 08/25/2009 |
| NPI Last Update Date: | 08/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 9265 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |