Individual
EDNA KATHALEEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC-AD
Contact information
Practice address
4201 PRIMROSE AVE, BALTIMORE, MD 21215-3305
(410) 764-8560
(410) 764-9114
Mailing address
10 MONTROSE AVE, OWINGS MILLS, MD 21117-4132
(443) 722-6760
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
AC2022
MD
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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