Individual
DONTERIO MARQUELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
277 MARTIN LUTHER KING JR BLVD STE 203, MACON, GA 31201-3498
(478) 745-2811
Mailing address
277 MARTIN LUTHER KING JR BLVD STE 203, MACON, GA 31201-3498
(478) 745-2811
(478) 745-0881
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC012306
GA
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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