Healthcare Provider Details

I. General information

NPI: 1568891042
Provider Name (Legal Business Name): ASIA SMITH HHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 03/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 L ST NW STE 900
WASHINGTON DC
20036-4208
US

IV. Provider business mailing address

379 37TH PL SE APT 102
WASHINGTON DC
20019-3270
US

V. Phone/Fax

Practice location:
  • Phone: 202-829-1111
  • Fax:
Mailing address:
  • Phone: 202-770-8978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberHHA9593
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA9593
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: