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General NPI Number Information
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NPI Number | 1194576165
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Entity Type | Individual
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Provider Name | RACHAEL SMITH BS, CHW
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 2446 JOLLY RD STE B
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City | OKEMOS
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State | MI
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Zip | 48864-3514
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Country | US
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Telephone | 517-253-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 N HAGADORN RD # 2W
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City | EAST LANSING
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State | MI
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Zip | 48823-2320
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Country | US
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Telephone | 517-364-8187
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | MI
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