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General NPI Number Information
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NPI Number | 1962828988
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Entity Type | Individual
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Provider Name | LORI SMITH LPC
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Gender | Female
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Dates
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Enumeration Date | 03/14/2014
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Last Update Date | 03/14/2014
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Provider Practice Location Address
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Address Line | 13460 N 94TH DR STE. J2
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City | PEORIA
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State | AZ
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Zip | 85381-4835
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Country | US
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Telephone | 623-910-1067
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Fax |
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Provider Business Mailing Address
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Address Line | 13151 N 71ST DR
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City | PEORIA
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State | AZ
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Zip | 85381-6001
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Country | US
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Telephone | 623-910-1067
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 14163
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License Number State | AZ
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