Individual
CAROL JEAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
80 ST HWY 310 STE 1, CANTON, NY 13617-1493
(315) 386-2189
(315) 386-2435
Mailing address
80 ST HWY 310 STE 1, CANTON, NY 13617-1493
(315) 386-2189
(315) 386-2435
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
205555
NY
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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