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General NPI Number Information
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NPI Number | 1043726417
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Entity Type | Individual
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Provider Name | ELIZABETH SMITH
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Gender | Female
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 7288 HANOVER GREEN DR
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-1709
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Country | US
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Telephone | 855-772-8847
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Fax |
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Provider Business Mailing Address
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Address Line | 27777 INKSTER RD STE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-5312
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Country | US
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Telephone | 855-772-8847
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH005399
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA483
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0133001129
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License Number State | VA
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