Provider Information for 1821732033
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NICOLE ANN SMITH LCSW
Sex: Female
NPI: 1821732033
Last Updated: 2022-04-24
Certification Date: 2022-04-24
Certification Date: 2022-04-24
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1821732033 | ||||||||||||||
| Enumeration Date | 2022-04-24 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 1921 BAYONNE ST SARASOTA, FL 34231-7737 United States Phone: 908-507-8753 | Fax: | ||||||||||||||
| Primary Practice Address | 7905 E 21ST AVE DENVER, CO 80238-4119 United States Phone: 908-507-8753 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 1921 BAYONNE ST | ||||||||||||||
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