Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | CSW004128 | GA |
NPI | 1003118522 |
---|---|
Provider Name | Evalee Paige Smith |
First Address | Savannah, GA 31405-6808 |
Second Address | Savannah, GA 31405-6808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2010 |
Last Update Date | 03/12/2010 |