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General NPI Number Information
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NPI Number | 1053227587
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Entity Type | Individual
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Provider Name | AUTUMN DESRI SMITH
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Gender | Female
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Dates
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Enumeration Date | 08/24/2026
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Last Update Date | 08/24/2026
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Provider Practice Location Address
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Address Line | 411 WOLF LEDGES PKWY STE 410
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City | AKRON
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State | OH
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Zip | 44311-1054
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Country | US
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Telephone | 330-298-8661
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 NEWTON ST APT J
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City | AKRON
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State | OH
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Zip | 44305-3069
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Country | US
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Telephone | 330-802-0703
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OH
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