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Individual
WALTER A SMART
Active
Individual
WALTER A SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802013586
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6802013586
STATE OF MICHIGAN LICENSE
MI
Enumeration date
02/15/2008
Last updated
02/15/2008
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