Provider Demographics
NPI:1285476580
Name:SMITH, ANN L (MSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7083 BROOKVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-7202
Mailing Address - Country:US
Mailing Address - Phone:770-262-1441
Mailing Address - Fax:
Practice Address - Street 1:7083 BROOKVIEW WAY
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-7202
Practice Address - Country:US
Practice Address - Phone:770-262-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty