Individual
DR. ROBERTA ANN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D, HSPP, RN
Contact information
Practice address
951 E 86TH ST, EXECUTIVE NORTH, SUITE 140, INDIANAPOLIS, IN 46240-1849
(317) 408-7816
(317) 598-9924
Mailing address
3029 RIVER BAY DR N, INDIANAPOLIS, IN 46240-2985
(317) 408-7816
(317) 598-9924
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20042362A
IN
163WP0808X
Psychiatric/Mental Health Registered Nurse
28115908A
IN
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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