Provider Demographics
NPI:1215159660
Name:SMITH, ANNE ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 COLE AVE
Mailing Address - Street 2:APT. #110
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1591
Mailing Address - Country:US
Mailing Address - Phone:214-789-7279
Mailing Address - Fax:
Practice Address - Street 1:3737 COLE AVE
Practice Address - Street 2:APT. #110
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1591
Practice Address - Country:US
Practice Address - Phone:214-789-7279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2008-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31815103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical