Individual
GINA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1665 S GREEN ST, TUPELO, MS 38804-6556
(662) 377-2189
(662) 377-2263
Mailing address
1665 S GREEN ST, TUPELO, MS 38804-6556
(662) 377-2189
(662) 377-2263
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C1397
MS
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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