ETHAN SMITH

HOMER, AK
NPI1982339610
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2022-07-18
Last Update Date2022-07-18
Business Address
ETHAN SMITH
51310 TIMBER BAY CT
HOMER, AK 99603-9812
Phone number: 907-235-3250
Mailing Address
ETHAN SMITH
PO BOX 876741
WASILLA, AK 99687-6741
Phone number:
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