Individual
GWENDOLYN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4010 DUPONT CIR STE 226, LOUISVILLE, KY 40207-4847
(502) 896-8006
Mailing address
9911 MICHAEL EDWARD DR, LOUISVILLE, KY 40291-1160
(502) 302-2466
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
269566
KY
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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