| Nicole Smith Irrv Tr 08012010 | |
|
420 Prairie Run Aledo TX 76008-1170 | |
| (760) 676-0085 | |
| Not Available |
| Full Name | Nicole Smith Irrv Tr 08012010 |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 420 Prairie Run, Aledo, Texas |
| Authorized Official Name and Position | Nicole Smith (MANAGEMENT) |
| Authorized Official Contact | 8563019997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Smith Irrv Tr 08012010 8 Logan Dr Cherry Hill NJ 08034-1734 Ph: (856) 301-9997 | Nicole Smith Irrv Tr 08012010 420 Prairie Run Aledo TX 76008-1170 Ph: (760) 676-0085 |
| NPI Number | 1245981257 |
|---|---|
| Provider Enumeration Date | 01/11/2022 |
| Last Update Date | 01/11/2022 |
| Certification Date | 01/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245981257 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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