Individual
DR. RONALD GLENN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
55 LAKE HAVASU AVE S, STE. F-365, LAKE HAVASU CITY, AZ 86403-0938
(928) 854-2373
(928) 680-9811
Mailing address
2035 MESQUITE AVE, STE. C, LAKE HAVASU CITY, AZ 86403-5894
(928) 854-2373
(928) 680-9811
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0954
AZ
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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