Provider Demographics
NPI:1255375408
Name:SMYTH, FRANCES WATERHOUSE (MA)
Entity type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:WATERHOUSE
Last Name:SMYTH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2425 W LAKE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7656
Mailing Address - Country:US
Mailing Address - Phone:919-845-7114
Mailing Address - Fax:919-781-8678
Practice Address - Street 1:7200 STONEHENGE DR
Practice Address - Street 2:SUITE 206
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1620
Practice Address - Country:US
Practice Address - Phone:919-845-7114
Practice Address - Fax:919-781-8678
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3716101YP2500X
NC1215103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling