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General NPI Number Information
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NPI Number | 1528716859
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Entity Type | Individual
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Provider Name | DEANNA SMITH MS.ED
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Gender | Female
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 9201 ARBORETUM PKWY
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-5402
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Country | US
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Telephone | 804-332-7188
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Fax |
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Provider Business Mailing Address
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Address Line | 112 CROMWELL PKWY APT 302
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City | NORFOLK
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State | VA
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Zip | 23505-3599
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Country | US
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Telephone | 757-201-0598
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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 | 0704007489
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License Number State | VA
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