Individual
MRS. LISA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1055 UPCHURCH DR, OLIVE BRANCH, MS 38654-5575
(901) 603-1444
Mailing address
1055 UPCHURCH DR, OLIVE BRANCH, MS 38654-5575
(901) 603-1444
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
11651-C
AR
1041C0700X
Clinical Social Worker
CSW0000006936
TN
1041C0700X
Clinical Social Worker
Primary
LCSW00005158
TN
Other
Enumeration date
02/07/2007
Last updated
06/08/2022
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