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General NPI Number Information
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NPI Number | 1871688234
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Entity Type | Individual
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Provider Name | RAYMOND HARRY SMITH JR. M.S.,P.P.S.,M.F.T.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 9613 OAKHAM WAY
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City | ELK GROVE
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State | CA
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Zip | 95757
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Country | US
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Telephone | 916-521-2677
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Fax |
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Provider Business Mailing Address
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Address Line | 9613 OAKHAM WAY
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City | ELK GROVE
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State | CA
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Zip | 95757-5116
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Country | US
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Telephone | 916-521-2677
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFC40507
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License Number State | CA
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