Healthcare Provider Details

I. General information

NPI: 1952212052
Provider Name (Legal Business Name): ASHBY SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6409 ABERCORN ST STE A1
SAVANNAH GA
31405-5715
US

IV. Provider business mailing address

6409 ABERCORN ST STE A1
SAVANNAH GA
31405-5715
US

V. Phone/Fax

Practice location:
  • Phone: 912-299-2221
  • Fax:
Mailing address:
  • Phone: 912-299-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-2840703
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: