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Individual
MR. KENNETH DAVID SMITH
Active
Individual
MR. KENNETH DAVID SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
124154
CA
1041C0700X
Clinical Social Worker
43576
ID
1041C0700X
Clinical Social Worker
Primary
L11298
OR
Other
Enumeration date
08/03/2016
Last updated
08/29/2024
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