Individual
MICHAEL C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
209 CLINTON ST, BROOKLYN, NY 11201-6268
(917) 693-0762
Mailing address
209 CLINTON ST, BROOKLYN, NY 11201-6268
(917) 693-0762
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
006451-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00925897
—
NY
01
—
164634
ELDERPLAN
—
Enumeration date
04/26/2006
Last updated
10/19/2010
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