Healthcare Provider Details

I. General information

NPI: 1902846926
Provider Name (Legal Business Name): DIONNE SMITH PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 09/09/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SUMMIT RD
CINCINNATI OH
45237-2621
US

IV. Provider business mailing address

1101 SUMMIT RD
CINCINNATI OH
45237-2621
US

V. Phone/Fax

Practice location:
  • Phone: 513-948-3808
  • Fax: 513-948-8631
Mailing address:
  • Phone: 513-948-3808
  • Fax: 513-948-8631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5863
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: