Individual
TERRENCE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1491 MAIN ST, WILLIMANTIC, CT 06226-1914
(860) 456-1769
Mailing address
1491 MAIN ST, WILLIMANTIC, CT 06226-1914
(860) 456-1769
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000600
CT
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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