Individual
TANWANDA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
549 COX RD, GASTONIA, NC 28054-0628
(704) 865-1558
Mailing address
515 CLANTON RD, CHARLOTTE, NC 28217-1309
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23592
NC
Other
Enumeration date
11/17/2016
Last updated
10/31/2018
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