Individual
DR. ALAN JAY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2618 AVENUE C, SCOTTSBLUFF, NE 69361-1680
(308) 632-8547
(308) 632-0135
Mailing address
2618 AVENUE C, SCOTTSBLUFF, NE 69361-1680
(308) 632-8547
(308) 632-0135
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
296
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08317
BLUE CROSS BLUE SHIELD
NE
05
—
10025416200
—
NE
Enumeration date
08/10/2005
Last updated
08/02/2012
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