| NPI | 1366007536 |
|---|---|
| Other Name | GWEN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 15235) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 15513) |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |