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General NPI Number Information
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NPI Number | 1043671183
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Entity Type | Organization
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Legal Business Name | SMILE THERAPY SERVICES
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Dates
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Enumeration Date | 03/17/2016
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Last Update Date | 03/17/2016
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Provider Practice Location Address
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Address Line | 800 KENILWORTH AVENUE NE 313
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City | WASHINGTON
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State | DC
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Zip | 20019
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Country | US
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Telephone | 240-324-6524
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Fax |
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Provider Business Mailing Address
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Address Line | 800 KENILWORTH AVENUE NE 313
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City | WASHINGTON
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State | DC
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Zip | 20019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRISTI VENABLE
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Credential | LPC
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Telephone | 202-374-3750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PRC14547
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License Number State | DC
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