Individual
DR. JOSHUA DE'VON SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, DPC, LPC
Contact information
Practice address
1520 29TH AVE STE 32, GULFPORT, MS 39501-2843
(601) 292-9107
Mailing address
PO BOX 10632, GULFPORT, MS 39505-0632
(601) 292-2107
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2662
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
03/31/2009
Last updated
09/19/2024
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