Individual
MARCIA MAHAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
104 70 QUEENS BOULEVARD, SUITE 307, QUEENS, NY 11375
(718) 275-6010
(718) 275-6062
Mailing address
10470 QUEENS BLVD, SUITE 307, FOREST HILLS, NY 11375-3638
(718) 275-6010
(718) 275-6062
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25596
NY
Other
Enumeration date
02/14/2011
Last updated
01/25/2017
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