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Individual

WANDA BO SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
710 GRAND AVE, SUITE 6, BILLINGS, MT 59101-5852
(406) 690-1616
(406) 294-2925
Mailing address
PO BOX 20794, BILLINGS, MT 59104-0794
(406) 690-1616
(406) 294-2925

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1113 LCPC
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000741360
BCBS
MT
05
0256165
MT
Enumeration date
02/21/2007
Last updated
11/13/2009
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