Individual
JACQUELINE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
210 E COTTONWOOD LN, CASA GRANDE, AZ 85122-2514
(520) 836-1688
(520) 421-2708
Mailing address
210 E COTTONWOOD LN, CASA GRANDE, AZ 85122-2514
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-18314
AZ
Other
Enumeration date
10/24/2019
Last updated
10/28/2019
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