Provider Demographics
NPI:1043577885
Name:SMITH, YUNETTA S (NCC)
Entity type:Individual
Prefix:
First Name:YUNETTA
Middle Name:S
Last Name:SMITH
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 WILMA RUDOLPH BLVD # 107
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5844
Mailing Address - Country:US
Mailing Address - Phone:931-338-8882
Mailing Address - Fax:
Practice Address - Street 1:2515 WILMA RUDOLPH BLVD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5822
Practice Address - Country:US
Practice Address - Phone:931-338-8882
Practice Address - Fax:888-974-3396
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health