Leslie Tucker Smith, MFT

Individual provider Active NPI Marriage & Family Therapist · Georgetown, CA

NPI 1619004710 · NPPES record last updated Jun 29, 2011

Key facts

NPI
1619004710
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
50124 (CA)
Practice address
6087 Front St
Suite 2
Georgetown, CA 95634-9358
Phone
(530) 919-1616
Fax
(530) 333-4114
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 50124 CA Yes

Addresses

Primary practice location

6087 Front St
Suite 2
Georgetown, CA 95634-9358

Mailing address

PO Box 360
Georgetown, CA 95634-0360
Phone (530) 333-1331

Other providers in Georgetown, CA

All providers in Georgetown, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.