Provider Demographics
NPI:1720078868
Name:YOUNT-SMETANA, MICHELLE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:MARIE
Last Name:YOUNT-SMETANA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41750 RANCHO LAS PALMAS DR
Mailing Address - Street 2:SUITE L6
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-5511
Mailing Address - Country:US
Mailing Address - Phone:760-674-9100
Mailing Address - Fax:760-674-9211
Practice Address - Street 1:41750 RANCHO LAS PALMAS DR
Practice Address - Street 2:SUITE L6
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-5511
Practice Address - Country:US
Practice Address - Phone:760-674-9100
Practice Address - Fax:760-674-9211
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20432103TF0000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist