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General NPI Number Information
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NPI Number | 1174197917
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Entity Type | Individual
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Provider Name | HEATHER A SMITH RBT
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Gender | Female
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Dates
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Enumeration Date | 05/17/2021
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Last Update Date | 03/08/2025
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Provider Practice Location Address
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Address Line | 148 DOUGHTY BLVD STE 260
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City | INWOOD
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State | NY
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Zip | 11096-2054
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Country | US
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Telephone | 917-688-9644
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Fax |
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Provider Business Mailing Address
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Address Line | 1404 S 14TH ST
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City | RICHMOND
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State | IN
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Zip | 47374-7051
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Country | US
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Telephone | 765-969-8029
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-23-314357
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | RBT-23-314357
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License Number State | IN
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