Smith, Mary Bob

Smith, Mary Bob is an sole proprietor health care provider with primary practice located at 703 E Marshall Ave Suite 4002, Longview TX 75601-5500. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Smith, Mary Bob can be contacted via phone (903) 234-9556.

Contact Information

Primary practice address
703 E Marshall Ave Suite 4002 Longview TX 75601-5500
Phone: (903) 234-9556
Fax: (903) 663-0378
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 10164 Texas
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 002974-036483 Texas

Profile Details

NPI number 1477565422
LBN Legal business name Smith, Mary Bob
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 11th, 2006
Last updated Jul 8th, 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 1477565422 NPPES
Other 3318LC BCBS TEXAS

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