Individual
MICAH JOVAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 N GREEN VALLEY PKWY STE 116-118, HENDERSON, NV 89014-0273
(702) 605-2766
Mailing address
2501 N GREEN VALLEY PKWY STE 116-118, HENDERSON, NV 89014-0273
(702) 605-2766
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02294-I
BOARD OF EXAMINERSFOR ALCOHOL AND DRUG AND GAMBELING COUNSELORS
NV
Enumeration date
03/15/2018
Last updated
03/15/2018
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