Provider Information for 1851836548
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LORETTA SMITH MSW, LCSW
Sex: Female
NPI: 1851836548
Last Updated: 2020-09-29
Certification Date: 2020-09-29
Certification Date: 2020-09-29
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1851836548 | ||||||||||||
| Enumeration Date | 2017-01-04 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 887 BROWNSBURG, IN 46112-0887 United States Phone: 732-267-3713 | Fax: | ||||||||||||
| Primary Practice Address | 10308 KINGS GAP WAY INDIANAPOLIS, IN 46234-3645 United States Phone: 732-267-3713 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 6655 E US HIGHWAY 36 5638 PROFESSIONAL CIR | ||||||||||||
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