Individual
NICOLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16940 HIGHWAY 14 STE C, MOJAVE, CA 93501-1238
(661) 824-5020
Mailing address
16940 HIGHWAY 14 STE C, MOJAVE, CA 93501-1238
(661) 824-5020
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5873
CA
Other
Enumeration date
10/17/2016
Last updated
02/13/2019
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