Healthcare Provider Details

I. General information

NPI: 1447990338
Provider Name (Legal Business Name): CHRISTOPHER MILLER SMITH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 03/30/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BEHAVIOR FRONTIERS, LLC 7375 WOODWARD AVE, SUITE 2800
DETRIOT MI
48202
US

IV. Provider business mailing address

BEHAVIOR FRONTIERS, LLC 7375 WOODWARD AVE, SUITE 2800 D
DETRIOT MI
48202
US

V. Phone/Fax

Practice location:
  • Phone: 888-922-2843
  • Fax: 855-568-2494
Mailing address:
  • Phone: 888-922-2843
  • Fax: 855-568-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: