Individual
HEIDI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1301 1ST AVE N, FORT DODGE, IA 50501-4203
(515) 408-6779
Mailing address
1301 1ST AVE N, FORT DODGE, IA 50501-4203
(515) 408-6779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0413702
—
IA
Enumeration date
02/07/2020
Last updated
03/22/2021
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