Individual
NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 N CROATAN HWY STE G, KILL DEVIL HILLS, NC 27948-9356
(252) 207-9511
Mailing address
246 W KITTY HAWK RD, KITTY HAWK, NC 27949-4707
(252) 207-9511
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CADC-27093
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1810
PRACTICE USE IN NORTH CAROLINA
NC
Enumeration date
05/09/2022
Last updated
05/09/2022
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