Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 1041C0700X | Clinical Social Worker | 100110 | CA |
NPI | 1003116781 |
---|---|
Provider Name | Ms. Kara Leigh Smith |
First Address | Long Beach, CA 90807-4957 |
Second Address | Venice, CA 90291-2623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2010 |
Last Update Date | 25/02/2021 |