Individual
POLLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
556 CLINTON AVE S, ROCHESTER, NY 14620-1105
(585) 442-8422
Mailing address
3537 COLE RD, MARION, NY 14505-9715
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
33600
NY
Other
Enumeration date
09/13/2022
Last updated
01/05/2023
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