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Individual

MS. LISA JEANETTE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
545 NW CAROLYN LN, POULSBO, WA 98370-9750
(360) 900-8711
Mailing address
545 NW CAROLYN LN, POULSBO, WA 98370-9750
(360) 900-8711

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904013876
VA
1041C0700X
Clinical Social Worker
Primary
LW00009464
WA

Other

Enumeration date
04/02/2008
Last updated
06/19/2023
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