Individual
COURTNEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
17100 W 12 MILE RD, SUITE 1, SOUTHFIELD, MI 48076-2115
(248) 443-1995
Mailing address
17100 W 12 MILE RD, SUITE 1, SOUTHFIELD, MI 48076-2115
(248) 443-1995
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801094821
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801094821
LIMITED LICENSE SOCIAL WORK PERMANENT ID
MI
Enumeration date
09/24/2012
Last updated
09/24/2012
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