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General NPI Number Information
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NPI Number | 1356765713
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Entity Type | Individual
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Provider Name | PHINA SMITH-HAMILTON LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 20100 MIDWAY AVE
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City | SOUTHFIELD
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State | MI
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Zip | 48075-7533
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Country | US
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Telephone | 313-304-2353
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Fax |
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Provider Business Mailing Address
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Address Line | 23461 HAGGERTY RD
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City | NOVI
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State | MI
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Zip | 48375-3727
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Country | US
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Telephone | 313-304-2353
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801078286
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License Number State | MI
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