| Doctor Name: | PROF. KELLY SMITH |
| NPI Number: | 1821200148 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 9777 |
| Business Practice Address: | 108 Leamington Spa Whitehouse, TX - 75791 |
| Business Phone Number: | 9036570790 |
| Business Fax Number: | |
| Mailing Address: | Po Box 131533, TYLER |
| State: | TX |
| Postal Code: | 757131533 |
| Phone Number: | 9036570790 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 9777 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |