Individual
CARRIE LOUISE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4700 ENTERPRISE WAY, MODESTO, CA 95356
(209) 550-6013
Mailing address
218 DELTA AVE, BRENTWOOD, CA 94513-1603
(209) 550-6013
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
LCSW87808
CA
Other
Enumeration date
04/11/2007
Last updated
07/08/2024
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