Provider Demographics
NPI:1679153936
Name:SMITH, EARNEST CLEMENT JR (CERTIFIED LIFE COACH)
Entity Type:Individual
Prefix:MR
First Name:EARNEST
Middle Name:CLEMENT
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:CERTIFIED LIFE COACH
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Mailing Address - Street 1:2025 WISE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-6161
Mailing Address - Country:US
Mailing Address - Phone:318-794-0750
Mailing Address - Fax:
Practice Address - Street 1:2025 WISE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-6161
Practice Address - Country:US
Practice Address - Phone:318-794-0750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
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