Individual
MRS. BRENDA L SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 PENDLETON ST, TEMPLE, TX 76504-2947
(254) 742-1524
(254) 742-0789
Mailing address
601 PENDLETON ST, TEMPLE, TX 76504-2947
(254) 742-1524
(254) 742-0789
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
24041
TX
1041C0700X
Clinical Social Worker
Primary
24041
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162921405
—
TX
01
—
87327Q
BCBS
TX
Enumeration date
07/21/2005
Last updated
03/06/2019
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