Doctor Name: | MS. CORETHA DENISE SMITH |
NPI Number: | 1518210483 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CERTIFIED ADDICTION |
License Number: | 007 |
Business Practice Address: | 136 South Main Street Belle Glade, FL - 33430 |
Business Phone Number: | 5619960500 |
Business Fax Number: | 5619928333 |
Mailing Address: | Po Box 1465, 136 South Main Street BELLE GLADE |
State: | FL |
Postal Code: | 33430 |
Phone Number: | 5619960500 |
Fax Number: | 5619928333 |
NPI Enumeration Date: | 10/17/2012 |
NPI Last Update Date: | 10/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 007 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |