| NPI | 1982936464 |
|---|---|
| Former Name | SUZANNE RENEE' SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR R5063) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR 02-03-09) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 02-03-09) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 12-06-07) | |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2018-03-30 |