Gary Tyquan Smith

NPI #1003495409 in Brewster, New York

Provider Information

NPI Number: 1003495409
Entity Type: Individual
Name: Gary Tyquan Smith
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Apr 5, 2021
Last Updated: Apr 5, 2021

Practice Location

Address: 400 DOANSBURG RD
City: Brewster
State: New York
ZIP Code: 10509
Phone: (845) 279-2995

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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