Individual
MRS. LATASHA MACHELLE-KELLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-A
Contact information
Practice address
210 ASHBURY SQ, MEBANE, NC 27302-8741
(910) 778-3049
Mailing address
210 ASHBURY SQ, MEBANE, NC 27302-8741
(910) 778-3049
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
P007600
NC
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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