Healthcare Provider Details

I. General information

NPI: 1346153780
Provider Name (Legal Business Name): CANDI SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 EXECUTIVE CT
LITTLE ROCK AR
72205-4550
US

IV. Provider business mailing address

333 EXECUTIVE CT
LITTLE ROCK AR
72205-4550
US

V. Phone/Fax

Practice location:
  • Phone: 501-526-8756
  • Fax:
Mailing address:
  • Phone: 501-519-3022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: