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Individual
JACOB SHANE SMITH
Active
Individual
JACOB SHANE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8519497-6004
UT
101YM0800X
Mental Health Counselor
8519497-6101
UT
101YM0800X
Mental Health Counselor
—
NULL
Other
Enumeration date
02/21/2022
Last updated
05/20/2024
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