| NPI | 1407443666 |
|---|---|
| Former Name | DEITRE M SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103460) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701010828) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0704010252) | |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2022-04-08 |