Individual
TANYA SUE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 DOWNEY AVE, MODESTO, CA 95354-1208
(209) 341-1824
Mailing address
PO BOX 1112, SALIDA, CA 95368-1112
(209) 610-4787
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APCC11511
CA
Other
Enumeration date
09/19/2022
Last updated
02/04/2025
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