Individual
CHARLENE A SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
358 STILES AVE, ORANGE PARK, FL 32073-4012
(904) 264-8311
(904) 264-8377
Mailing address
358 STILES AVE, ORANGE PARK, FL 32073-4012
(904) 264-8311
(904) 264-8377
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15897
FL
Other
Enumeration date
06/13/2018
Last updated
11/20/2019
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