Individual
BROOKELYNN MAE FREED SMITH
Active
Individual
BROOKELYNN MAE FREED SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MSW, BSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2020022699
MO
1041C0700X
Clinical Social Worker
2020022699
MO
1041C0700X
Clinical Social Worker
Primary
2022038812
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020022699
MASTER OF SOCIAL WORK LICENSE
MO
01
—
2022038812
CLINICAL SOCIAL WORK LICENSE
MO
Enumeration date
08/24/2020
Last updated
09/30/2022
Update your record
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