Most Relevant Information
Provider Data
| NPI Number: | 1003481573 |
| Provider Name: | LARISSA SMITH LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 65056 |
Most Important Dates
| Enumeration Date: | 05/26/2021 |
| Last Updated: | 05/14/2024 |
Provider Practice Location
5380 OLD BULLARD RD STE 600-129
TYLER
TX
757033607
Practice Location Phone/Fax
| Phone: | 9037073187 |
| Fax: |
Provider Mailing Location
5380 OLD BULLARD RD STE 600-129
TYLER
TX
757033607
Provider Mailing Phone/Fax
| Phone: | 9037073187 |
| Fax: |