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Individual

JARVIS CORNIELUS SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.A., CAP, VBHC

Contact information

Practice address
1002 N SEMORAN BLVD, ORLANDO, FL 32807-3531
(407) 275-8939
Mailing address
1002 N SEMORAN BLVD, ORLANDO, FL 32807-3531
(407) 275-8939

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YA0400X
FL
Enumeration date
04/25/2018
Last updated
04/25/2018
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