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Individual

ELLEN SMITHEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, ATR-BC

Contact information

Practice address
4700 STAGGERBRUSH RD APT 315, AUSTIN, TX 78749-1056
(248) 759-8463
Mailing address
4700 STAGGERBRUSH RD APT 315, AUSTIN, TX 78749-1056
(248) 759-8463

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
21-448
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
86-2216004
SECRETARY OF STATE
MI
Enumeration date
08/04/2022
Last updated
08/04/2022
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