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General NPI Number Information
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NPI Number | 1639029010
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Entity Type | Organization
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Legal Business Name | PENNWALT THERAPEUTICS, PLLC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 140 QUAIL DRIVE
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City | DUDLEY
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State | NC
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Zip | 28333
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Country | US
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Telephone | 919-583-5247
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Fax | 800-916-5488
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Provider Business Mailing Address
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Address Line | PO BOX 761
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City | DUDLEY
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State | NC
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Zip | 28333-0761
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Country | US
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Telephone | 919-583-5247
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Fax | 800-916-5488
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Authorized Official
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Title or Position | OWNER/ PSYCHOTHERAPIST
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Name | MRS. JENNIFER SCOTT SMITH
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Credential | LCSW, LCAS
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Telephone | 919-583-5247
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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 |
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License Number State |
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