Individual
MICHELE L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-7550
Mailing address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-7550
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
003909
CT
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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