Healthcare Provider Details

I. General information

NPI: 1710802376
Provider Name (Legal Business Name): SIERRA JULIETT SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 FAIRGROVE AVE
HAMILTON OH
45011-1966
US

IV. Provider business mailing address

4341 WOOD THRUSH CT
MIAMISBURG OH
45342-0853
US

V. Phone/Fax

Practice location:
  • Phone: 513-785-4895
  • Fax:
Mailing address:
  • Phone: 513-785-4895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2607934-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: