Individual
CAROL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15218 E FACKLY SPRINGS RD, KINGMAN, AZ 86401-8578
(928) 303-6812
Mailing address
PO BOX 3720, FLAGSTAFF, AZ 86003-3720
(928) 526-0779
(928) 526-0284
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
215253
AZ
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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