Individual
MR. CHARLES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
933 45TH ST, MANGONIA PARK, FL 33407-2413
(561) 841-1000
Mailing address
933 45TH ST, MANGONIA PARK, FL 33407-2413
(561) 841-1000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18654
FL
Other
Enumeration date
12/15/2020
Last updated
12/15/2020
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