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Organization
THERESA M SMITH
Active
Organization
THERESA M SMITH
Active
Other names
South of Boston Healing
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A PUOPOLO (ADMINISTRATIVE ASSISTANT)
(508) 583-9800
Entity
Organization
Contact information
Practice address
820 PEARL ST, BROCKTON, MA 02301-4411
(508) 583-9800
(508) 583-9802
Mailing address
820 PEARL ST, BROCKTON, MA 02301-4411
(508) 583-9800
(508) 583-9802
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RN/NP115563
MA
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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