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Individual

DR. WILLIAM MICHAEL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
640 GOOSEBERRY DR UNIT 908, LONGMONT, CO 80503-6434
(303) 651-9290
(303) 651-7158
Mailing address
640 GOOSEBERRY DR UNIT 908, LONGMONT, CO 80503-6434
(303) 651-9290
(303) 651-7158

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2110
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07211014
CO
Enumeration date
06/06/2006
Last updated
05/09/2013
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