Individual
KAITLIN M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PC
Contact information
Practice address
1045 KLOTZ RD, BOWLING GREEN, OH 43402-4820
(419) 352-7588
(419) 354-4977
Mailing address
410 N PROSPECT ST, BOWLING GREEN, OH 43402-2021
(419) 308-5383
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C0900482
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0900482
STATE OF OHIO COUNSELOR, SOCIAL WORKER, MARRIAGE & FAMILY THERAPIST BOARD
OH
Enumeration date
05/19/2011
Last updated
05/19/2011
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