Individual
DR. JOHN THOMAS SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
171 SLOAN RD, PHOENIXVILLE, PA 19460-6108
(610) 933-2334
Mailing address
171 SLOAN RD, PHOENIXVILLE, PA 19460-6108
(610) 933-2334
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS001947
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS001947
PSYCHOLOGIST LICENSE
PA
Enumeration date
04/10/2007
Last updated
07/08/2007
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