Individual
ANITA SMULLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2643 N SERICIN CIR, MESA, AZ 85215-1639
(815) 342-4594
Mailing address
2643 N SERICIN CIR, MESA, AZ 85215-1639
(815) 342-4594
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180010956
IL
101YP2500X
Professional Counselor
Primary
LPC19007
AZ
101YP2500X
Professional Counselor
LPCC12356
CA
Other
Enumeration date
02/19/2016
Last updated
08/08/2024
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