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Individual

DR. JUSTIN MARK SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
1830 S ALMA SCHOOL RD STE 112, MESA, AZ 85210-3086
(480) 730-6222
Mailing address
1830 S ALMA SCHOOL RD STE 112, MESA, AZ 85210-3086
(480) 730-6222

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
003910
AZ
103TC0700X
Clinical Psychologist
2612-57
WI
103TC0700X
Clinical Psychologist
6301019264
MI

Other

Enumeration date
04/19/2023
Last updated
04/19/2023
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