Individual
BRAETAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
10 PARK PLZ, BOSTON, MA 02116-3933
(617) 222-5381
Mailing address
12 BAILEY ST, EVERETT, MA 02149-4402
(860) 961-4632
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
104100000X
Social Worker
000227778
MA
1041C0700X
Clinical Social Worker
Primary
LICSW128519
MA
Other
Enumeration date
08/08/2017
Last updated
10/15/2024
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