Individual
GWENDOLYN W. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
501 MIZE ST., LAFAYETTE, GA 30728
(706) 638-5580
(706) 639-2041
Mailing address
PO BOX 1027, LA FAYETTE, GA 30728-1027
(706) 638-5580
(706) 639-2041
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002421
GA
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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