Healthcare Provider Details

I. General information

NPI: 1598656936
Provider Name (Legal Business Name): WYSH AALYIAH ROPER-SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 TROY ST
DAYTON OH
45404-1852
US

IV. Provider business mailing address

813 TROY ST
DAYTON OH
45404-1852
US

V. Phone/Fax

Practice location:
  • Phone: 937-982-1500
  • Fax: 937-982-1500
Mailing address:
  • Phone: 937-982-1500
  • Fax: 937-982-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: