Individual
JESSICA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
(719) 269-9373
Mailing address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
(719) 269-9386
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0001037
CO
101YP2500X
Professional Counselor
Primary
LPC.0012585
CO
Other
Enumeration date
09/18/2014
Last updated
12/18/2019
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