Individual
MR. JERRELL F SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3851 ROGER BROOKE DRIVE, MCHE-QD (CREDS), FORT SAM HOUSTON, TX 78234-6200
(210) 916-2460
Mailing address
3851 ROGER BROOKE DRIVE, MCHE-QD (CREDS), FORT SAM HOUSTON, TX 78234-6200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001342
IA
Other
Enumeration date
08/02/2012
Last updated
03/20/2017
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