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Individual

CAMILLA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCA

Contact information

Practice address
120 W WALNUT ST, MAYFIELD, KY 42066-2285
(270) 251-3260
(270) 251-3260
Mailing address
120 W WALNUT ST, MAYFIELD, KY 42066-2285
(270) 251-3260
(270) 251-3260

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCCA00218286
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LPCCA00218286
KY
Enumeration date
04/06/2015
Last updated
04/06/2015
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