Provider Demographics
NPI:1477748820
Name:SMITH, JANET VALERIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:VALERIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-4740
Mailing Address - Country:US
Mailing Address - Phone:620-235-4537
Mailing Address - Fax:
Practice Address - Street 1:1701 S BROADWAY, PITTSBURG STATE UNIVERSITY
Practice Address - Street 2:DEPARTMENT OF PSYCHOLOGY AND COUNSELING
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762
Practice Address - Country:US
Practice Address - Phone:620-235-4537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLP1165103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical