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Individual

ADA SMALLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
199 DUNDERBERG RD, CENTRAL VALLEY, NY 10917-3507
(845) 460-6400
(845) 460-6041
Mailing address
199 DUNDERBERG RD, CENTRAL VALLEY, NY 10917-3507
(845) 460-6400
(845) 460-6041

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
074314
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122299580
NY
Enumeration date
04/17/2012
Last updated
04/17/2012
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