Individual
DR. NICOLE LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., L.P.
Contact information
Practice address
10273 YELLOW CIRCLE DR, MINNETONKA, MN 55343-9144
(952) 215-3759
(952) 401-9805
Mailing address
2841 BRYANT AVE S APT 130, MINNEAPOLIS, MN 55408-4896
(414) 232-7277
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LP5504
MN
Other
Enumeration date
12/15/2011
Last updated
06/26/2014
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