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General NPI Number Information
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NPI Number | 1972286581
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Entity Type | Individual
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Provider Name | BENJAMIN SMITH AMFT
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Gender | Male
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 08/10/2023
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Provider Practice Location Address
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Address Line | 3438 N 200 W
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City | LEHI
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State | UT
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Zip | 84043-4178
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Country | US
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Telephone | 615-456-2242
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 W BLUEGRASS BLVD STE. 200
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City | LEHI
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State | UT
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Zip | 84043-4190
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Country | US
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Telephone | 615-456-2242
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4731866-3904
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License Number State | UT
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