Individual
BRYAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
66 BARIBEAU DR, SUITE 1A, BRUNSWICK, ME 04011-3230
(207) 373-6971
(207) 373-6959
Mailing address
66 BARIBEAU DR, SUITE 1A, BRUNSWICK, ME 04011-3230
(207) 373-6971
(207) 373-6959
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC4693
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102140100
—
ME
Enumeration date
04/13/2011
Last updated
04/13/2011
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