Individual
ANTOINETTE SMIDTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 542-8770
Mailing address
1790 CLINTON AVE APT 3B, BRONX, NY 10457-6753
(718) 542-8770
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3677
NY
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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