Provider Demographics
NPI:1821466095
Name:SMITH, CAMILLE KATHLEEN
Entity Type:Individual
Prefix:MISS
First Name:CAMILLE
Middle Name:KATHLEEN
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LITTLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-1410
Mailing Address - Country:US
Mailing Address - Phone:603-361-1649
Mailing Address - Fax:
Practice Address - Street 1:635 ROGERS ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-3855
Practice Address - Country:US
Practice Address - Phone:978-382-8601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker