Healthcare Provider Details

I. General information

NPI: 1306729579
Provider Name (Legal Business Name): ALEXANDRIA SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7610 PENNSYLVANIA AVE STE 203
DISTRICT HEIGHTS MD
20747-4716
US

IV. Provider business mailing address

11141 GEORGIA AVE APT 310
SILVER SPRING MD
20902-7677
US

V. Phone/Fax

Practice location:
  • Phone: 301-420-1972
  • Fax:
Mailing address:
  • Phone: 502-645-6743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: