Brian Wallace Smith MA

NPI 1205127735 - Counselor - 101YM0800X

NPI Details
NPI 1205127735
Gender Male
Enumeration Date 05/02/2011
Last Updated 05/02/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
3830 S CUSHMAN ST
FAIRBANKS AK, 99701-7530, US
Phone (907) 455-1416
Fax (907) 455-1460
Business Location
1300 GARAY ST
FAIRBANKS AK, 99709-3169, US
Phone (907) 687-7805
Fax
Toxanomy
Taxonomy Code 101YM0800X
License State
License Number
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According to our database, Brian Wallace Smith MA NPI is 1205127735, taxonomy code is 101YM0800X Brian Wallace Smith MA physically located at 3830 S Cushman St, Fairbanks AK, 99701-7530. NPI Number Brian Wallace Smith MA has the Individual type.

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1205127735 NPI number is provided on an as is basis without warranty of any kind. 1205127735 is maintained by the National Plan & Provider Enumeration System. The contents of Brian Wallace Smith MA are for informational purposes only.