Individual
KENNETH R. SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
50 MOODY ST, SACO, ME 04072-1536
(207) 294-4657
(207) 294-4649
Mailing address
48 TREMAINE ST, PORTLAND, ME 04103-3308
(207) 772-1542
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CC1622
ME
Other
Enumeration date
04/05/2006
Last updated
07/08/2007
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