Organization
ROGER SMITH, LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER M SMITH LCSW (OWNER)
(985) 974-8172
Entity
Organization
Contact information
Practice address
14317 HICKORY DR, PONCHATOULA, LA 70454-6653
(985) 974-8172
(985) 386-0826
Mailing address
14317 HICKORY DR., PONCHATOULA, LA 70454-6653
(985) 974-8172
(985) 386-0826
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5099
LA
Other
Enumeration date
07/14/2009
Last updated
07/14/2009
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