Healthcare Provider Details

I. General information

NPI: 1528190147
Provider Name (Legal Business Name): ALEXANDER HAMILTON SMITH ED.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 MONTGOMERY RD
CINCINNATI OH
45242-7789
US

IV. Provider business mailing address

16 W HENRY CLAY AVE
FT WRIGHT KY
41011-3613
US

V. Phone/Fax

Practice location:
  • Phone: 513-852-9481
  • Fax:
Mailing address:
  • Phone: 859-341-3024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1948
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: