MEDICARE: ANDREA SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1275991614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA SMITH

Provider Business Mailing Address
First Line	:	27 S SHERMAN ST
Second Line	:	APT. 206
City	:	DENVER
State	:	CO
Zip	:	80209-1662
Country	:	US
Telephone Number	:	720-401-0472
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 S SHERMAN ST
Second Line	:	APT. 206
City	:	DENVER
State	:	CO
Zip	:	80209-1662
Country	:	US
Telephone Number	:	720-401-0472
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2016
Last Update Date	:	02/29/2016

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Directions to “ ANDREA SMITH ” Practice Location

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