Individual
DR. EZRA E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2450 E RIVER RD, TUCSON, AZ 85718-6526
(520) 795-7750
Mailing address
2450 E RIVER RD, TUCSON, AZ 85718-6526
(631) 319-0151
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY-005110
AZ
103T00000X
Psychologist
PSY-005110
AZ
103TC0700X
Clinical Psychologist
PSY-005110
AZ
Other
Enumeration date
05/17/2019
Last updated
05/31/2019
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