Individual
KIM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4801 INDIAN SCHOOL RD NE, STE 200, ALBUQUERQUE, NM 87110-3970
(505) 884-8595
(505) 281-1049
Mailing address
4801 INDIAN SCHOOL RD NE, STE 200, ALBUQUERQUE, NM 87110-3970
(505) 884-8595
(505) 281-1049
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
325
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N0468
—
NM
Enumeration date
10/04/2006
Last updated
07/09/2007
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