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NPI Code Detail

MEDICARE: MISS JENNIFER MARIE SMITHSON

MEDICARE: MISS JENNIFER MARIE SMITHSON
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
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor929CA

General Provider Information

NPI Number : 1043365414
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER MARIE SMITHSON
Provider Business Mailing Address
First Line : 17800 US HIGHWAY 18
Second Line :
City : APPLE VALLEY
State : CA
Zip : 92307-1221
Country : US
Telephone Number : 760-955-3682
Fax Number : 760-242-1425
Provider Business Practice Location Address
First Line : 17800 US HIGHWAY 18
Second Line :
City : APPLE VALLEY
State : CA
Zip : 92307-1221
Country : US
Telephone Number : 760-955-3682
Fax Number : 760-242-1425
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 09/29/2014

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Directions to “ MISS JENNIFER MARIE SMITHSON ” Practice Location

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