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General NPI Number Information
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NPI Number | 1184285793
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Entity Type | Individual
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Provider Name | DANA MICHELLE SMITH
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Gender | Female
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 606 E SPRING ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-5066
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Country | US
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Telephone | 931-303-0665
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Fax | 931-303-0667
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Provider Business Mailing Address
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Address Line | 104 LONE PINE DR APT D
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City | LEBANON
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State | TN
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Zip | 37087-8663
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Country | US
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Telephone | 615-664-9529
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | TN
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