Individual
MR. CHARLES MARCUS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
11861 NELWOOD ST, WILLIS, TX 77318-7278
(936) 333-6230
Mailing address
11861 NELWOOD ST, WILLIS, TX 77318-7278
(936) 333-6230
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10920
TX
101YP2500X
Professional Counselor
Primary
64645
TX
Other
Enumeration date
01/06/2013
Last updated
01/06/2013
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