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Individual

MICHAEL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LCAS-A

Contact information

Practice address
216 STEWART PKWY, WASHINGTON, NC 27889-4972
(252) 946-0585
(252) 946-0580
Mailing address
216 STEWART PKWY, WASHINGTON, NC 27889-4972
(252) 946-0585
(252) 946-0580

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28052
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6005782
NC
Enumeration date
07/08/2022
Last updated
07/08/2022
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