Individual
DAVID WADE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
313 VISTA ST SW, FORT WALTON BEACH, FL 32548-6519
(850) 244-2621
Mailing address
313 VISTA ST SW, FORT WALTON BEACH, FL 32548-6519
(850) 244-2621
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT1019
FL
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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