Individual
RENEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18603 BLACKMOOR ST, DETROIT, MI 48234-3719
(313) 526-3269
Mailing address
18603 BLACKMOOR ST, DETROIT, MI 48234-3719
(313) 542-2497
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
149028399
IL
Other
Enumeration date
08/05/2016
Last updated
01/13/2025
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