| Doctor Name: | DR. JENNIFER LORETTA SMITH |
| NPI Number: | 1982026100 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 015747-1 |
| Business Practice Address: | 546 High Mountain Rd North Haledon, NJ - 075082606 |
| Business Phone Number: | 9734270397 |
| Business Fax Number: | 9734239580 |
| Mailing Address: | 44 Point Breeze Ave, BREEZY POINT |
| State: | NY |
| Postal Code: | 116971621 |
| Phone Number: | 9173552031 |
| Fax Number: | 9734239580 |
| NPI Enumeration Date: | 01/07/2014 |
| NPI Last Update Date: | 05/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 015747-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |