Most Relevant Information
Provider Data
| NPI Number: | 1003368424 |
| Provider Name: | TAMICA SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/02/2016 |
| Last Updated: | 11/02/2016 |
Provider Practice Location
348 W 79TH ST
SHREVEPORT
LA
711064820
Practice Location Phone/Fax
| Phone: | 3186888190 |
| Fax: |
Provider Mailing Location
348 W 79TH ST
SHREVEPORT
LA
711064820
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |