Individual
CHARLES ETHAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
14 CLIFFWOOD AVE STE 100, MATAWAN, NJ 07747-3930
(732) 551-5990
Mailing address
363 HIGHLAND ST, SOUTH AMBOY, NJ 08879-1936
(732) 551-5990
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-452909
NJ
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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