Individual
MRS. ANDREA NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
780 E GILBERT ST, SAN BERNARDINO, CA 92415-1003
(909) 387-7194
Mailing address
780 E GILBERT ST, SAN BERNARDINO, CA 92415-1003
(909) 387-7194
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
IMF81751
CA
106H00000X
Marriage & Family Therapist
Primary
LMFT101028
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/18/2013
Last updated
12/14/2017
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