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NPI Code Detail

MEDICARE: ALLIE JO SMITH

MEDICARE: ALLIE JO SMITH
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 Analyst1-23-70281IN

General Provider Information

NPI Number : 1447020052
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLIE JO SMITH
Provider Business Mailing Address
First Line : 9740 BLYTH DR
Second Line :
City : EVANSVILLE
State : IN
Zip : 47725-8997
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4655 ROSEBUD LN
Second Line :
City : NEWBURGH
State : IN
Zip : 47630-9366
Country : US
Telephone Number : 812-213-8031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2024
Last Update Date : 06/27/2026

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Directions to “ ALLIE JO SMITH ” Practice Location

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