Individual
GEORGETTE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4417 BRUNER AVE, BRONX, NY 10466-1213
(646) 773-7124
Mailing address
4417 BRUNER AVE, BRONX, NY 10466-1213
(646) 773-7124
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
103992
NY
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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