Individual
MARK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
43 HATCH DR, SUITE 210, CARIBOU, ME 04736-2161
(207) 764-6340
(207) 768-6430
Mailing address
43 HATCH DR, SUITE 210, CARIBOU, ME 04736-2161
(207) 764-6340
(207) 768-6430
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275956211
—
ME
Enumeration date
01/28/2014
Last updated
01/28/2014
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