Provider Demographics
NPI:1659429744
Name:SMILEY, COLETTE MARY (MFT)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:MARY
Last Name:SMILEY
Suffix:
Gender:
Credentials:MFT
Other - Prefix:
Other - First Name:COLETTE
Other - Middle Name:MARY
Other - Last Name:SMILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:37013 N STONEWARE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-5290
Mailing Address - Country:US
Mailing Address - Phone:805-641-2100
Mailing Address - Fax:805-641-2103
Practice Address - Street 1:37013 N STONEWARE DR
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85140-5290
Practice Address - Country:US
Practice Address - Phone:805-641-2100
Practice Address - Fax:805-641-2103
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC21876106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist