Individual
MR. KENNETH LEROY SMITH SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC014651
Contact information
Practice address
332 HASTY RD NE, ROME, GA 30161-7795
(762) 357-4921
Mailing address
1838 REDMOND CIR NW STE E, ROME, GA 30165-1379
(706) 270-5022
(762) 320-5365
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC14651
GA
Other
Enumeration date
04/24/2024
Last updated
06/16/2024
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