Provider Demographics
NPI:1972018331
Name:SMITH, CHRISTIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIN
Middle Name:
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 1:1070 HECKLE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2853
Mailing Address - Country:US
Mailing Address - Phone:803-909-7298
Mailing Address - Fax:
Practice Address - Street 1:1070 HECKLE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2855
Practice Address - Country:US
Practice Address - Phone:803-909-7298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist