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NPI Code Detail

MEDICARE: TIARA SMITH

MEDICARE:   TIARA  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
1106H00000XMarriage & Family TherapistMI4042NV

General Provider Information

NPI Number : 1801557806
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIARA SMITH
Provider Business Mailing Address
First Line : 6847 TREE HAVEN CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-5174
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6655 W SAHARA AVE STE C203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-0850
Country : US
Telephone Number : 702-900-2784
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2022
Last Update Date : 01/06/2022

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Directions to “ TIARA SMITH ” Practice Location

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