Provider Demographics
NPI:1912358938
Name:SMITH, SABLE ALEXANDRE'
Entity Type:Individual
Prefix:
First Name:SABLE
Middle Name:ALEXANDRE'
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 LITCHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-1233
Mailing Address - Country:US
Mailing Address - Phone:617-704-0085
Mailing Address - Fax:
Practice Address - Street 1:98 LITCHFIELD ST
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-1233
Practice Address - Country:US
Practice Address - Phone:617-704-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor