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Individual
ELIJAH ECKERT SMITH
Active
Individual
ELIJAH ECKERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174400000X
REHAB ACTIVITY LEADER
CA
Enumeration date
02/26/2013
Last updated
02/26/2013
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