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General NPI Number Information
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NPI Number | 1912050873
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Entity Type | Individual
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Provider Name | BIRGIT M SMART PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 2495 SHREVEPORT HIGHWAY 71 N
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City | PINEVILLE
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State | LA
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Zip | 71360
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Country | US
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Telephone | 318-473-0010
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Fax | 318-483-5096
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Provider Business Mailing Address
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Address Line | DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER P. O. BOX 69004
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City | ALEXANDRIA
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State | LA
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Zip | 71306
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Country | US
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Telephone | 318-473-0010
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Fax | 318-483-5096
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1160
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License Number State | LA
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