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General NPI Number Information
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NPI Number | 1558852103
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Entity Type | Individual
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Provider Name | TATIANA FELICIA MEJIA-SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/18/2018
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 4019 WOODLAND PARK BLVD STE 113
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City | ARLINGTON
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State | TX
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Zip | 76013-4468
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Country | US
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Telephone | 682-206-8691
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Fax |
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Provider Business Mailing Address
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Address Line | 6100 VERANDAS CIR APT 822
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City | FORT WORTH
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State | TX
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Zip | 76132-4165
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Country | US
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Telephone | 817-229-5627
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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 | 58492
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License Number State | TX
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