Individual
DOROTHY S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
406 MARQUIS ST, JACKSON, MS 39206-4345
(769) 251-3952
Mailing address
406 MARQUIS ST, JACKSON, MS 39206-4345
(769) 251-3952
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C8590
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018209
—
MS
Enumeration date
06/19/2013
Last updated
03/17/2018
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