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General NPI Number Information
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NPI Number | 1154523280
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Entity Type | Individual
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Provider Name | DAVID MICHAEL SMITH PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8931 HURON ST
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City | THORNTON
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State | CO
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Zip | 80260-6806
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Country | US
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Telephone | 303-853-3849
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Fax |
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Provider Business Mailing Address
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Address Line | 420 S LOOMIS AVE
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City | FORT COLLINS
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State | CO
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Zip | 80521-2545
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Country | US
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Telephone | 970-416-1480
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 747
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License Number State | CO
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