Individual
GWENDOLYN MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3535 KNIGHT LN TRLR 8, LAKE CHARLES, LA 70605-1233
(337) 986-9197
(337) 588-4179
Mailing address
PO BOX 13047, LAKE CHARLES, LA 70612-3047
(337) 855-9023
(337) 855-1829
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15235
LA
1041C0700X
Clinical Social Worker
15513
FL
Other
Enumeration date
05/03/2019
Last updated
05/03/2019
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