Most Relevant Information
Provider Data
| NPI Number: | 1003252289 |
| Provider Name: | DEIADRA LOUISE SMIDT LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 1316 |
Most Important Dates
| Enumeration Date: | 05/15/2013 |
| Last Updated: | 05/15/2013 |
Provider Practice Location
1949 SUGARLAND DR
SHERIDAN
WY
828015755
Practice Location Phone/Fax
| Phone: | 3077516376 |
| Fax: | 3076741825 |
Provider Mailing Location
1949 SUGARLAND DR
SHERIDAN
WY
828015755
Provider Mailing Phone/Fax
| Phone: | 3077516376 |
| Fax: | 3076741825 |