Individual
PETER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., LCDC
Contact information
Practice address
896 ROBIN RANCH RD, LOCKHART, TX 78644-4578
(512) 376-2101
(512) 398-5696
Mailing address
PO BOX 577, LOCKHART, TX 78644-0577
(512) 376-2101
(512) 398-5696
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
9265
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9265
TDSHS CHEMICAL DEPENDENCY COUNELSOR
TX
Enumeration date
08/25/2009
Last updated
08/25/2009
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