Individual
MR. GAROLD WAYNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
4900 NE TRI COUNTY LINE RD, CAMERON, MO 64429-7543
(913) 669-9209
Mailing address
4900 NE TRI COUNTY LINE RD, CAMERON, MO 64429-7543
(913) 669-9209
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8764
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8764
KANSAS BEHAVIORAL SCIENCE REGULATORY BOARD
KS
Enumeration date
01/24/2014
Last updated
01/24/2014
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