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NPI 1558682930

NPI 1558682930 : RACHELLE D SMITH PHD, LPC : OVERLAND, MO

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General NPI Number Information
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    NPI Number           |    1558682930
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    Entity Type          |    Individual 
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    Provider Name        |    RACHELLE D SMITH PHD, LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/19/2010
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    Last Update Date     |    06/13/2016
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Provider Practice Location Address
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    Address Line         |    9100 OVERLAND PLZ 
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    City                 |    OVERLAND
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    State                |    MO
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    Zip                  |    63114-6123
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    Country              |    US
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    Telephone            |    314-744-9027
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    Fax                  |    314-571-9698
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Provider Business Mailing Address
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    Address Line         |    9100 OVERLAND PLZ 
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    City                 |    OVERLAND
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    State                |    MO
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    Zip                  |    63114-6123
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    Country              |    US
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    Telephone            |    314-744-9027
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    Fax                  |    314-571-9698
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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        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    2010009689
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    License Number State |    MO
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