Individual
HOLLY R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
703 W CANAL ST, PICAYUNE, MS 39466-3918
(601) 749-9477
(601) 889-1265
Mailing address
PO BOX 661495, BIRMINGHAM, AL 35266-1495
(205) 979-5882
(205) 979-1248
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C2733
MS
106H00000X
Marriage & Family Therapist
C2733
MS
Other
Enumeration date
08/05/2008
Last updated
08/05/2008
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