MEDICARE: MRS. DARA BETH SMITHSON M.S.

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1083777692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DARA BETH SMITHSON M.S.

Provider Business Mailing Address
First Line	:	128 CENTRAL AVE
Second Line	:
City	:	WEST TRENTON
State	:	NJ
Zip	:	08628-2905
Country	:	US
Telephone Number	:	609-434-0360
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 CENTRAL AVE
Second Line	:
City	:	WEST TRENTON
State	:	NJ
Zip	:	08628-2905
Country	:	US
Telephone Number	:	609-434-0360
Fax Number	:

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/08/2007

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