Individual
MR. SEPTEMBER PORTUONDO-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
112 FRANKLIN PL, WOODMERE, NY 11598-1217
(516) 374-3671
(516) 374-7864
Mailing address
112 FRANKLIN PL, WOODMERE, NY 11598-1217
(516) 374-3671
(516) 374-7864
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/15/2009
Last updated
01/15/2009
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