Smith, Jeanette M
Smith, Jeanette M is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Smith, Jeanette M can be contacted via phone (602) 933-0414.Contact Information
Primary practice address
1919 E Thomas Rd
Phoenix AZ 85016-7710
Phone: (602) 933-0414
Fax: (602) 933-4252
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 2013 | Arizona |
Profile Details
| NPI number | 1508828385 |
|---|---|
| LBN Legal business name | Smith, Jeanette M |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 5th, 2006 |
| Last updated | Mar 27th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508828385 | NPPES |
| Arizona | MEDICAID | 148173 |
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