Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003027343 |
---|---|
Provider Name | Dr. Shawn T Smith |
First Address | Golden, CO 80401-2221 |
Second Address | Denver, CO 80209-3019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 08/07/2007 |