Healthcare Provider Details

I. General information

NPI: 1659201788
Provider Name (Legal Business Name): ALICIA MICHELLE SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6189 LEHMAN DR STE 105
COLORADO SPRINGS CO
80918-5408
US

IV. Provider business mailing address

3110 FIREWEED DR
COLORADO SPRINGS CO
80918-4507
US

V. Phone/Fax

Practice location:
  • Phone: 720-998-5232
  • Fax:
Mailing address:
  • Phone: 720-998-5232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0008725
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: