Individual
MARY SMYTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
42 DELSEA DR S, GLASSBORO, NJ 08028-2621
(856) 863-0006
Mailing address
42 DELSEA DR S, GLASSBORO, NJ 08028-2621
(856) 863-0006
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37AC00198300
NJ
Other
Enumeration date
06/09/2015
Last updated
07/13/2016
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