Provider Demographics
NPI:1215018270
Name:SMITH, JESSICA NOLL (BS)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:NOLL
Last Name:SMITH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S 22ND ST
Mailing Address - Street 2:PITTSBURGH
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2143
Mailing Address - Country:US
Mailing Address - Phone:412-381-2100
Mailing Address - Fax:412-381-2100
Practice Address - Street 1:70 S 22ND ST
Practice Address - Street 2:PITTSBURGH
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2143
Practice Address - Country:US
Practice Address - Phone:412-381-2100
Practice Address - Fax:412-381-2100
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)