Individual
GABRIELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC-A, LCAS-A
Contact information
Practice address
4748 EMMA CANNON RD, AYDEN, NC 28513-7538
(315) 719-5616
Mailing address
4748 EMMA CANNON RD, AYDEN, NC 28513-7538
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-26341
NC
101YM0800X
Mental Health Counselor
Primary
A16567
NC
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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