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General NPI Number Information
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NPI Number | 1811985690
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Entity Type | Individual
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Provider Name | VONCEIL CORNELIUS SMITH PHD
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Gender | Female
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 6707 TAYLOR CIR
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City | MONTGOMERY
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State | AL
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Zip | 36117-7706
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Country | US
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Telephone | 334-272-3889
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Fax |
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Provider Business Mailing Address
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Address Line | 300 SOUTH TWINING STREET BUILDING 760
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City | MAXWELL AFB
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State | AL
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Zip | 36112-6219
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Country | US
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Telephone | 334-953-4943
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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