Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1376147082 |
---|---|
Provider Name | Dr. Davon Ramel Smith |
First Address | Chesapeake, VA 23320-3355 |
Second Address | Chesapeake, VA 23320-3355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2020 |
Last Update Date | 23/11/2020 |