MEDICARE: DR. CARA LEANN SMITH PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PY 7361	FL

General Provider Information

NPI Number	:	1003032343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARA LEANN SMITH PSY.D.

Provider Business Mailing Address
First Line	:	8155 CHELSEA CT APT A
Second Line	:
City	:	LAKE CLARKE SHORES
State	:	FL
Zip	:	33406-8414
Country	:	US
Telephone Number	:	561-641-3086
Fax Number	:	561-641-3086

Provider Business Practice Location Address
First Line	:	1218 SOUTH OLIVE AVE.
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-6725
Country	:	US
Telephone Number	:	561-641-3086
Fax Number	:	561-641-3086

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	07/08/2007

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