Individual
JUDY L SMITH-DANDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(479) 236-9539
Mailing address
601 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(479) 236-9539
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
05229
CT
1041C0700X
Clinical Social Worker
Primary
2204-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004225901
—
CT
Enumeration date
06/20/2006
Last updated
07/11/2014
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