Individual
JONATHAN W SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3540 CLEMMONS RD STE 70, CLEMMONS, NC 27012-9394
(336) 303-8642
Mailing address
2800 HERMITAGE DR, WINSTON SALEM, NC 27103-4206
(336) 303-8642
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A19048
NC
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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