Individual
ANISSA SMALLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 S FORT HOOD ST STE 103B, KILLEEN, TX 76542-1681
(254) 239-1027
Mailing address
4201 INDIGO DR, KILLEEN, TX 76542-4621
(813) 785-6244
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
68483
TX
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/27/2019
Last updated
07/10/2024
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