Individual
ETHAN BENNET SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
95 CIRCULAR AVE, HAMDEN, CT 06514-4004
(203) 288-6253
(203) 288-0948
Mailing address
94 LIVINGSTON ST, APT. 25, NEW HAVEN, CT 06511-2444
(301) 466-4646
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/28/2009
Last updated
07/28/2009
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