Individual
MR. ROBERT L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.W.
Contact information
Practice address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
(228) 497-1363
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
04/08/2013
Last updated
04/08/2013
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