Individual
KEITH CHARLES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
400 EAST AVE, HILTON, NY 14468-1254
(585) 392-1000
Mailing address
400 EAST AVE, HILTON, NY 14468-1254
(585) 392-1000
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
R037413-1
NY
Other
Enumeration date
09/21/2010
Last updated
09/21/2010
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