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Individual
LARRY SMITH
Active
Individual
LARRY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2413A
NC
101YM0800X
Mental Health Counselor
2413A
NC
Other
Enumeration date
12/06/2012
Last updated
03/17/2018
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