Individual
ANGELA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1481 WINDSOR DR, SAN BERNARDINO, CA 92404-5416
(909) 361-6470
Mailing address
11905 ELAHL CT, MORENO VALLEY, CA 92555-1757
(951) 534-8310
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
138993
CA
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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