Individual
DR. MARDI MICHELE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4546 KENSINGTON DR, SAN DIEGO, CA 92116-3834
(619) 994-8627
Mailing address
543 JAVELIN CV, CORDOVA, TN 38018-7674
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2990
TN
103TC1900X
Counseling Psychologist
28408
CA
Other
Enumeration date
08/25/2011
Last updated
04/04/2024
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