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:
Health care specialties
| Specialty | Code | License # | 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 18 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 | 1477565422 | NPPES |
| Other | 3318LC | BCBS TEXAS |
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