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Individual

BRANDON SCOTT SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDCA

Contact information

Practice address
4747 MONROE ST, TOLEDO, OH 43623-4307
(419) 740-5709
Mailing address
2823 CHERRY ST, TOLEDO, OH 43608-1713
(419) 860-4570

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
168631
OH
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0324879
OH
Enumeration date
11/19/2018
Last updated
09/10/2021
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