Individual
MATTHEW SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
6692 SPRING ARBOR RD, JACKSON, MI 49201-9322
(517) 750-3869
(517) 750-3673
Mailing address
6692 SPRING ARBOR RD, JACKSON, MI 49201-9322
(517) 750-3869
(517) 750-3673
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301016989
MI
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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