Ryan Mark Smith, M.S.
Case Manager/Care Coordinator in Ammon, ID. Individual provider (NPI-1).
NPI number1851679633
StatusActive
Last updated in NPPESMar 3, 2021
Details
- NPI
- 1851679633
- Entity type
- Individual (NPI-1)
- Name
- Ryan Mark Smith
- Credential
- M.S.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 28, 2011
- Certification date
- Mar 3, 2021
- Last updated
- Mar 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | LPC-6566 | ID |
Practice location
2705 E 17th StAmmon, ID 83406-6601
Phone 208-346-7500
Mailing address
2705 E 17th StAmmon, ID 83406-6601
Phone 208-346-7500
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