Healthcare Provider Details

I. General information

NPI: 1003741109
Provider Name (Legal Business Name): KAILYN ELIZABETH SMITH-ALDRICH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W CHURCH AVE
LONGWOOD FL
32750-4105
US

IV. Provider business mailing address

1479 SUNSHADOW DR APT 207
CASSELBERRY FL
32707-9015
US

V. Phone/Fax

Practice location:
  • Phone: 407-339-6812
  • Fax:
Mailing address:
  • Phone: 386-235-6996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: