# DR. KELLY CRAGHILL FAGERBURG SMITH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1376896803
- **Gender:** F
- **Credential:** PSYD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 473 | ND | Yes |
| 103TC0700X | Clinical Psychologist | 473 | ND | — |

## Other

- **Enumeration date:** 10/22/2012
- **Last updated:** 03/11/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 17313 | — | ND |