NPI | 1699853705 |
---|---|
Former Name | NANCY A SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 1354) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO NLC0107312) |
103TC1900X Psychologist, Counseling (Licence: CO NLC0107312) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: CO NLC0107312) | |
363AM0700X Physician Assistant, Medical (Licence: CO 1354) | |
Enumeration Date | 2006-11-02 |
Last Update Date | 2018-03-17 |