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General NPI Number Information
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NPI Number | 1811677842
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Entity Type | Individual
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Provider Name | ASHLEY R SMITH
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Gender | Female
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 604 5TH ST SW
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City | ROCHESTER
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State | MN
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Zip | 55902-3256
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Country | US
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Telephone | 507-225-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 19 6TH ST SW
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City | EYOTA
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State | MN
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Zip | 55934-2917
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Country | US
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Telephone | 507-226-4256
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2367
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License Number State | MN
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