Provider Demographics
NPI:1750703823
Name:SMITH, TREMMIA (LPC)
Entity type:Individual
Prefix:
First Name:TREMMIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12881 ROAD 571
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-2300
Mailing Address - Country:US
Mailing Address - Phone:601-416-5718
Mailing Address - Fax:601-568-5032
Practice Address - Street 1:1120 E MAIN ST
Practice Address - Street 2:SUITE 21
Practice Address - City:PHILADELPHIA
Practice Address - State:MS
Practice Address - Zip Code:39350-2300
Practice Address - Country:US
Practice Address - Phone:601-416-5718
Practice Address - Fax:601-568-5032
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS922101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional