Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | LP1815 | KS |
NPI | 1134383193 |
---|---|
Provider Name | Dr. Ashley June Smith |
First Address | Kansas City, MO 64113-2266 |
Second Address | Kansas City, MO 64113-2266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2008 |
Last Update Date | 17/03/2020 |