Individual
KELLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCW
Contact information
Practice address
240 S. HUMAHUACA, PAHRUMP, NV 89048
(775) 751-7406
(775) 751-7409
Mailing address
240 S. HUMAHUACA, PAHRUMP, NV 89048
(775) 751-7406
(775) 751-7409
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/26/2012
Last updated
01/29/2020
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