Individual
GINA NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
221 EXECUTIVE CIR STE 221, SAVANNAH, GA 31406-4536
(912) 465-1238
Mailing address
1510 E 57TH ST, SAVANNAH, GA 31404-5461
(912) 675-2558
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
014002
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104522275
—
GA
Enumeration date
02/01/2023
Last updated
09/25/2023
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