Individual
JESSICA L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHCA
Contact information
Practice address
300 S SAINT LOUIS BLVD, SOUTH BEND, IN 46617-3043
(574) 406-1520
Mailing address
300 S SAINT LOUIS BLVD, SOUTH BEND, IN 46617-3043
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88000586A
IN
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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