Organization
WM. MICHAEL SMITH, PH.D, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MICHAEL SMITH PHD (OWNER)
(303) 651-9290
Entity
Organization
Contact information
Practice address
2919 17TH AVENUE, #210, LONGMONT, CO 80503
(303) 651-9290
(303) 651-7158
Mailing address
2727 NELSON RD, P-103, LONGMONT, CO 80503
(303) 651-9290
(303) 651-7158
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
C-2110
CO
Other
Enumeration date
12/18/2008
Last updated
08/11/2010
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