Individual
ANTOINETTE KATHLEEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAC, CDPT
Contact information
Practice address
1616 S GOLD ST STE 4, CENTRALIA, WA 98531-8930
(360) 807-4929
(360) 807-4160
Mailing address
1616 S GOLD ST STE 4, CENTRALIA, WA 98531-8930
(360) 807-4929
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60802177
WA
101YM0800X
Mental Health Counselor
CG60783142
WA
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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