Individual
MARY LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1909 COMMERCE AVE, CULLMAN, AL 35055-6151
(256) 736-4468
Mailing address
1909 COMMERCE AVE, CULLMAN, AL 35055-6151
(256) 736-4468
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330000025
—
AL
Enumeration date
11/01/2012
Last updated
11/01/2012
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