Provider Demographics
NPI:1710222328
Name:SMITH, JENNIFER SCHOLZ (PSYD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SCHOLZ
Last Name:SMITH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 FELTON PL
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2153
Mailing Address - Country:US
Mailing Address - Phone:770-386-8996
Mailing Address - Fax:770-386-8100
Practice Address - Street 1:17 FELTON PL
Practice Address - Street 2:SUITE A
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2153
Practice Address - Country:US
Practice Address - Phone:770-386-8996
Practice Address - Fax:770-386-8100
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3629103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist