Individual
MR. KELVIN MARTIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CIT
Contact information
Practice address
21089 SOUTH FRONTAGE ROAD, LACASSINE, LA 70650
(337) 936-9197
(337) 588-4179
Mailing address
105 REBECCA DR, LAFAYETTE, LA 70508-5965
(337) 661-4245
(337) 588-4179
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4238
LA
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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