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General NPI Number Information
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NPI Number | 1770894123
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Entity Type | Organization
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Legal Business Name | THOMAS M. SMITH, PSY.D.
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 04/22/2011
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Provider Practice Location Address
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Address Line | 125 N LINCOLN ST SUITE H
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City | DIXON
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State | CA
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Zip | 95620-3258
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Country | US
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Telephone | 707-235-8600
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Fax | 707-678-0666
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Provider Business Mailing Address
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Address Line | 125 N LINCOLN ST SUITE H
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City | DIXON
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State | CA
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Zip | 95620-3258
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Country | US
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Telephone | 707-235-8600
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Fax | 707-678-0666
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Authorized Official
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Title or Position | PSYCHOLOGIST OWNER
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Name | DR. THOMAS MICHAEL SMITH
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Credential | PSY.D.
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Telephone | 707-235-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 22707
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License Number State | CA
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