Healthcare Provider Details

I. General information

NPI: 1154285641
Provider Name (Legal Business Name): MARKIYAH SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 WOODSTOCK DR
FAIRFIELD OH
45014-5239
US

IV. Provider business mailing address

102 WOODSTOCK DR
FAIRFIELD OH
45014-5239
US

V. Phone/Fax

Practice location:
  • Phone: 513-816-4084
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: