Individual
MRS. KELLY R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
21 MAIN ST, TOWANDA, PA 18848-1803
(570) 265-2525
Mailing address
108 FRANKLIN ST, SAYRE, PA 18840-1305
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW129114
PA
1041C0700X
Clinical Social Worker
Primary
CW018796
PA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/04/2012
Last updated
03/17/2018
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