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Individual
MRS. COLLEEN MARY SMITH
Active
Individual
MRS. COLLEEN MARY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCII
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
03-03-64
OR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
11/28/2011
Last updated
01/31/2013
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