Individual
MR. MITCHELL THOMAS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
4144 E AMITY AVE, NAMPA, ID 83687-8802
(208) 465-4985
(208) 318-0218
Mailing address
4144 E AMITY AVE, NAMPA, ID 83687-8802
(208) 465-4985
(208) 318-0218
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4360
ID
Other
Enumeration date
07/28/2009
Last updated
07/28/2009
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