| NPI | 1801019500 |
|---|---|
| Former Legal Business Name | DWAYNE E SMITH PHD LLC |
| Entity Type | Organization |
| Authorized Contact | DWAYNE E SMITH Administrator 614-588-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |