Individual
CHANDRA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 S 2ND AVE STE 7, COVINA, CA 91723-3017
(626) 974-8122
Mailing address
510 S 2ND AVE STE 7, COVINA, CA 91723-3017
(626) 974-8122
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42592
CA
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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