Individual
MRS. PAMELA RUTH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
4700 N 16TH ST APT 120, PHOENIX, AZ 85016-4450
(225) 953-1923
Mailing address
4700 N 16TH ST APT 120, PHOENIX, AZ 85016-4450
(225) 953-1923
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904015785
VA
1041C0700X
Clinical Social Worker
107664
TX
1041C0700X
Clinical Social Worker
Primary
11144
LA
1041C0700X
Clinical Social Worker
LCSW2353
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
749814
AHCCCS PROVIDER ID
AZ
Enumeration date
01/19/2007
Last updated
10/01/2024
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