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Individual
MR. WILLIS SMITH
Active
Individual
MR. WILLIS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
P1701203
AR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
28278
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95017534
CA
Other
Enumeration date
01/29/2015
Last updated
02/02/2024
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