Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | P0000002355 | TN |
NPI | 1104945641 |
---|---|
Provider Name | Dr. William Joseph Smith |
First Address | Nashville, TN 37212-3014 |
Second Address | Nashville, TN 37212-3014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |