Individual
MARY JOSEPHINE SMART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11431 CLARKSON ST, NORTHGLENN, CO 80233-2114
(631) 579-9311
Mailing address
11431 CLARKSON ST, NORTHGLENN, CO 80233-2114
(631) 579-9311
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0002112
CO
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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