Individual
MISTY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
470 FOREST AVE, PORTLAND, ME 04101-2009
(207) 774-3570
(207) 774-3540
Mailing address
470 FOREST AVE, PORTLAND, ME 04101-2009
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
XL3838
ME
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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