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Individual
MR. RAYMOND A SMITH
Active
Individual
MR. RAYMOND A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA, SWT, CADC-M
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1-04119
MI
104100000X
Social Worker
Primary
6803082583
MI
224Z00000X
Occupational Therapy Assistant
5202005476
MI
Other
Enumeration date
07/18/2013
Last updated
07/18/2013
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