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Michael R Smith

Counselor, Addiction (Substance Use Disorder) in San Bernardino, CA. Individual provider (NPI-1).

NPI number1982163473
StatusActive
Last updated in NPPESFeb 28, 2024

Details

NPI
1982163473
Entity type
Individual (NPI-1)
Name
Michael R Smith
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 14, 2019
Certification date
Feb 28, 2024
Last updated
Feb 28, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YA0400X Counselor, Addiction (Substance Use Disorder)–CAYes
101YA0400X Counselor, Addiction (Substance Use Disorder)––

Practice location

349 W 11th St
San Bernardino, CA 92410-3513

Phone 909-884-0840

Mailing address

1100 N D St
San Bernardino, CA 92410-3524

Phone 909-884-0840

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