Individual
MRS. ANDREA KRISTIN SMOTHERS
Active
Individual
MRS. ANDREA KRISTIN SMOTHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10122
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1034004
PREF ONE
—
01
—
125740
MMSI
—
01
—
127608
U CARE
—
01
—
6231853
MEDICA
—
01
—
694S5SM
BCBS
—
01
—
990991034004
PEAK
—
Enumeration date
06/27/2006
Last updated
07/08/2007
Update your record
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