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General NPI Number Information
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NPI Number | 1821130683
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Entity Type | Individual
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Provider Name | DEBORAH JEAN SMITH PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 711 BALLARD ST
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-5441
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Country | US
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Telephone | 407-331-1903
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 LAKE WAUNATTA DR
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City | WINTER PARK
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State | FL
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Zip | 32792-8937
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Country | US
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Telephone | 407-619-1374
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY5675
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License Number State | FL
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