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General NPI Number Information
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NPI Number | 1104107200
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Entity Type | Individual
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Provider Name | LELA CLOER SMITH BCBA
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Gender | Female
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 1130 TEN ROD ROAD BUILDING C SUITE 201
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852
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Country | US
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Telephone | 401-639-8237
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Fax |
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Provider Business Mailing Address
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Address Line | 63 TAFT ST
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City | CRANSTON
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State | RI
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Zip | 02905-1349
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Country | US
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Telephone | 401-639-8237
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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 | 1-03-1412
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License Number State | FL
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