Individual
JEREMY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
41 MONTEBELLO RD, SUITE 200, PUEBLO, CO 81001-1379
(719) 545-2746
(719) 542-9638
Mailing address
41 MONTEBELLO RD, SUITE LL1, PUEBLO, CO 81001-1379
(719) 543-7115
(719) 543-7104
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC.0013489
CO
Other
Enumeration date
06/24/2014
Last updated
01/04/2017
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