Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 36638 | CA |
NPI | 1003237389 |
---|---|
Provider Name | Sabrina Smith |
First Address | Austin, TX 78702-3955 |
Second Address | Austin, TX 78745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2014 |
Last Update Date | 18/12/2021 |