Individual
DR. SUSAN SMART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
22409 ELLIS DAVIS RD, PRAIRIE HOME, MO 65068-2143
(660) 841-5031
Mailing address
22409 ELLIS DAVIS RD, PRAIRIE HOME, MO 65068-2143
(660) 841-5031
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2000163196
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
499774826
—
MO
Enumeration date
11/09/2006
Last updated
08/01/2016
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