Individual
DR. JESSE ALLEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1807 WATERLOO ST, PHILADELPHIA, PA 19122-2422
(256) 393-4039
Mailing address
1807 WATERLOO ST, PHILADELPHIA, PA 19122-2422
(256) 393-4039
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF001294
PA
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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