Individual
MARY A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
790 RIDGE RD FL 2, LACKAWANNA, NY 14218-1629
(716) 828-9500
Mailing address
790 RIDGE RD FL 2, LACKAWANNA, NY 14218-1629
(716) 828-9500
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/30/2026
Last updated
03/30/2026
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