Individual
SHANE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRSW
Contact information
Practice address
32 WHITE ROCK CIR, TILTON, NH 03276-5314
(603) 203-1848
Mailing address
32 WHITE ROCK CIR, TILTON, NH 03276-5314
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0394
NH
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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