Individual
MARK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
985450 NEBRASKA MED CTR, OMAHA, NE 68198-5450
(402) 559-8943
Mailing address
985450 NEBRASKA MED CTR, OMAHA, NE 68198-5450
(402) 559-8943
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
7248
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10225287200
—
NE
Enumeration date
10/26/2006
Last updated
07/08/2007
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