Individual
BONNIE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 KENNESAW AVE NW STE 250, MARIETTA, GA 30060-7944
(770) 485-3224
Mailing address
800 KENNESAW AVE NW STE 250, MARIETTA, GA 30060-7944
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13131
NE
103T00000X
Psychologist
—
—
Other
Enumeration date
09/07/2022
Last updated
08/15/2023
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