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Individual

MS. ELISE CHRISTINE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
1440 W 29TH ST, #100, LOVELAND, CO 80538-2459
(971) 775-7061
(907) 292-8194
Mailing address
2740 HEADWATER DR, FORT COLLINS, CO 80521-1140
(337) 302-1810

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
.09923917
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00000000000000
CO
Enumeration date
08/11/2015
Last updated
08/11/2015
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