Provider Demographics
NPI:1689011918
Name:SMITH, VI
Entity type:Individual
Prefix:
First Name:VI
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VI
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2901 N DALE MABRY HWY
Mailing Address - Street 2:APT #1513
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-2412
Mailing Address - Country:US
Mailing Address - Phone:610-334-8675
Mailing Address - Fax:
Practice Address - Street 1:8509 BENJAMIN RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1224
Practice Address - Country:US
Practice Address - Phone:813-872-8521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor