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General NPI Number Information
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NPI Number | 1285123893
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Entity Type | Organization
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Legal Business Name | JENNIFER SMITH PHD LLC
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 190 MAIN ST STE 306
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City | BRATTLEBORO
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State | VT
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Zip | 05301-2837
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Country | US
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Telephone | 802-755-5441
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Fax |
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Provider Business Mailing Address
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Address Line | 222 NEWFANE HILL RD
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City | NEWFANE
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State | VT
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Zip | 05345-9506
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Country | US
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Telephone | 802-755-5441
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JENNIFER MARIE SMITH
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Credential | PHD
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Telephone | 802-755-5441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 9419
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License Number State | MA
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