Individual
KELLI L SMART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
8766 EAST HWY 69, HUMBOLDT UNIFIED SCHOOL DISTRICT #22 SPECIAL SERVICE, PRESCOTT VALLEY, AZ 86314
(928) 759-4028
(928) 759-4030
Mailing address
1196 BUENA VISTA W, DEWEY, AZ 86327
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
710295
—
AZ
Enumeration date
02/20/2007
Last updated
07/26/2007
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