Individual
CAROLYN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
13180 JAMES MADISON HWY, ORANGE, VA 22960-2808
(540) 672-3388
Mailing address
PO BOX 382, ORANGE, VA 22960-0220
(540) 672-3388
(540) 672-2709
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810003008
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010063019
—
VA
01
—
137618
BCROSS
VA
Enumeration date
07/28/2006
Last updated
11/04/2018
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