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1609457597
ETHAN SMITH
BLOOMINGTON, IN
NPI
1609457597
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IN 39003923A)
Enumeration Date
2021-04-21
Last Update Date
2022-07-29
Business Address
ETHAN SMITH
420 S LANDMARK AVE
BLOOMINGTON, IN 47403-5000
Phone number: 812-369-4333
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Mailing Address
ETHAN SMITH
420 S LANDMARK AVE
BLOOMINGTON, IN 47403-5000
Phone number: 812-369-4333
Copy
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