Individual
JESSE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2288 AUTUMN FIRE CT, LAS VEGAS, NV 89117-8956
(702) 499-0848
Mailing address
2288 AUTUMN FIRE CT, LAS VEGAS, NV 89117-8956
(702) 499-0848
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
01173
NV
106H00000X
Marriage & Family Therapist
MI0137
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01173
BOARD OF EXAMINERS FOR MARRIAGE AND FAMILY THERAPISTS
NV
01
—
MI0137
STATE OF NEVADA BOARD OF MARRIAGE AND FAMILY THERAPIST
NV
Enumeration date
06/15/2009
Last updated
01/25/2017
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