Healthcare Provider Details

I. General information

NPI: 1245161389
Provider Name (Legal Business Name): SERENITY H BAKER-SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3139 M ST SE
WASHINGTON DC
20019-2129
US

IV. Provider business mailing address

3139 M ST SE
WASHINGTON DC
20019-2129
US

V. Phone/Fax

Practice location:
  • Phone: 703-870-9469
  • Fax:
Mailing address:
  • Phone: 703-870-9469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: