Provider Information for 1679173132
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JENNIFER SMITH LCSW
Sex: Female
NPI: 1679173132
Last Updated: 2020-10-26
Certification Date: 2020-10-26
Certification Date: 2020-10-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1679173132 | ||||||||
| Enumeration Date | 2020-10-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1481 W 10TH ST INDIANAPOLIS, IN 46202-2803 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 1481 W 10TH ST INDIANAPOLIS, IN 46202-2803 United States Phone: 317-760-6090 | Fax: | ||||||||
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