Individual
MS. THERESE M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAED- LISAC
Contact information
Practice address
4129 E VAN BUREN ST, PHOENIX, AZ 85008-6939
(602) 269-5331
(602) 269-5331
Mailing address
4129 E VAN BUREN ST, PHOENIX, AZ 85008-6939
(602) 269-5331
(602) 269-5331
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10977
AZ
Other
Enumeration date
03/19/2008
Last updated
03/19/2008
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