Individual
MR. RON DERRICK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LMHC, LCAC
Contact information
Practice address
724 N ILLINOIS ST, INDIANAPOLIS, IN 46204-1116
(317) 549-0333
(317) 549-6933
Mailing address
724 N ILLINOIS ST, INDIANAPOLIS, IN 46204-1116
(317) 549-0333
(317) 549-6933
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39000099A
IN
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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