| NPI | 1700016102 |
|---|---|
| Former Name | SUSAN LEE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 5758) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2015-11-03 |