Smart, Kelli L

Smart, Kelli L is an individual health care provider with primary practice located at 8766 East Hwy 69 Humboldt Unified School District #22 Special Service, Prescott Valley AZ 86314. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Smart, Kelli L can be contacted via phone (928) 759-4028.

Contact Information

Primary practice address
8766 East Hwy 69 Humboldt Unified School District #22 Special Service Prescott Valley AZ 86314
Phone: (928) 759-4028
Fax: (928) 759-4030
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X Arizona

Profile Details

NPI number 1184769820
LBN Legal business name Smart, Kelli L
Credentials PSYCHOLOGIST
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2007
Last updated Jul 26th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184769820 NPPES
Arizona MEDICAID 710295

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