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NPI Code Detail

MEDICARE: MS. MICHELLE SMART M.ED. BCBA

MEDICARE: MS. MICHELLE SMART M.ED. BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1215484001
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE SMART M.ED. BCBA
Provider Business Mailing Address
First Line : 6750 W 52ND AVE
Second Line :
City : ARVADA
State : CO
Zip : 80002-3928
Country : US
Telephone Number : 720-706-3396
Fax Number :
Provider Business Practice Location Address
First Line : 6750 W 52ND AVE
Second Line :
City : ARVADA
State : CO
Zip : 80002-3928
Country : US
Telephone Number : 720-706-3396
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2016
Last Update Date : 06/11/2023

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