| NPI | 1063837144 |
|---|---|
| Other Name | JACK RAE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 100708) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 60311) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2021-04-25 |