| NPI | 1053686261 |
|---|---|
| Former Name | NICOLE KENDALL SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 27086) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2012-03-21 |