Individual
MR. MICHAEL RICHARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
40 GINGER TRL, COVENTRY, RI 02816-8261
(401) 822-5376
Mailing address
40 GINGER TRAIL, COVENTRY, RI 02816
(401) 822-5376
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-8731
RI
Other
Enumeration date
11/18/2011
Last updated
11/18/2011
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