Provider Demographics
NPI:1194988238
Name:SMILEY, JUDITH ANN (LLPC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:SMILEY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2745 HILLCREST STREET
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-1232
Mailing Address - Country:US
Mailing Address - Phone:248-960-9778
Mailing Address - Fax:
Practice Address - Street 1:2745 HILLCREST
Practice Address - Street 2:
Practice Address - City:WIXOM
Practice Address - State:MI
Practice Address - Zip Code:48393-1232
Practice Address - Country:US
Practice Address - Phone:248-960-9778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009837101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health