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General NPI Number Information
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NPI Number | 1790920056
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Entity Type | Organization
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Legal Business Name | ANNE SMITH INC
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 12/15/2008
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Provider Practice Location Address
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Address Line | 6910 ROCKVIEW LANE
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City | DALLAS
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State | TX
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Zip | 75214
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Country | US
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Telephone | 214-789-7279
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Fax |
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Provider Business Mailing Address
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Address Line | 3737 COLE AVE #110
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City | DALLAS
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State | TX
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Zip | 75204-1591
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Country | US
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Telephone | 214-789-7279
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | ANNE SMITH
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Credential | PH.D.
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Telephone | 214-789-7279
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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 | 31815
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License Number State | TX
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