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Individual

EMACULETE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDCA

Contact information

Practice address
4977 NORTHCUTT PL, DAYTON, OH 45414-3839
(937) 387-6395
Mailing address
1007 N UNION ST, LIMA, OH 45801-2942

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA161690
OH
171M00000X
Case Manager/Care Coordinator
OH

Other

Enumeration date
12/21/2016
Last updated
07/12/2023
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