Individual
MS. DENISE SUSANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA, LISAC
Contact information
Practice address
382 E WILCOX DR, SIERRA VISTA, AZ 85635-2528
(520) 459-2290
(520) 459-5372
Mailing address
489 N ARROYO BLVD, NOGALES, AZ 85621-2644
(520) 287-4713
(520) 287-9794
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC1355
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
917536
AZ AHCCCS
AZ
Enumeration date
09/28/2006
Last updated
07/08/2007
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