Individual
DR. JASON WILLIAM SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
201 E 11TH ST, SPENCER, IA 51301-4436
(712) 262-2922
Mailing address
201 LAKE AVE, STORM LAKE, IA 50588-2432
(515) 419-1742
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00932
IA
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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