Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003358094 |
---|---|
Provider Name | Danielle Smith |
First Address | Lincoln, NE 68503-3528 |
Second Address | Lincoln, NE 68508-3533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2016 |
Last Update Date | 08/11/2016 |