Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP1600X | Pastoral Counselor | CA |
NPI | 1194486001 |
---|---|
Provider Name | Dr. Edward M Smink |
First Address | Atascadero, CA 93422-2125 |
Second Address | Atascadero, CA 93422-2125 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2022 |
Last Update Date | 03/01/2022 |