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Organization

LEWIS SMITH PH.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEWIS WILSON SMITH PH.D. (LICENSED PSYCHOLOGIST)
(248) 644-2955
Entity
Organization

Contact information

Practice address
1655 W BIG BEAVER RD, TROY, MI 48084-3501
(248) 644-2955
(248) 644-0237
Mailing address
1655 W BIG BEAVER RD, TROY, MI 48084-3501
(248) 644-2955
(248) 644-0237

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6201002143
MI
103T00000X
Psychologist
6301002143
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6301002143
LICENSED PSYCHOLOGIST
MI
Enumeration date
05/15/2006
Last updated
09/16/2014
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