Individual
DESIREE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
130 MAPLE ST, SPRINGFIELD, MA 01103-2202
(413) 737-9544
Mailing address
130 MAPLE ST, SPRINGFIELD, MA 01103-2202
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7699130-3502
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
12/22/2010
Last updated
08/05/2015
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