Individual
MR. CARROLL PAUL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
720 AVIGNON DR, SUITE 3, RIDGELAND, MS 39157-5166
(601) 259-6714
(601) 605-2710
Mailing address
225 DUBLIN CT, BRANDON, MS 39047-8035
(601) 259-6714
(601) 605-2710
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C0876
MS
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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