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NPI 1235993023

NPI 1235993023 : LISA DONITA SMITH : AKRON, OH

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General NPI Number Information
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    NPI Number           |    1235993023
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    Entity Type          |    Individual 
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    Provider Name        |    LISA DONITA SMITH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/12/2024
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    Last Update Date     |    02/13/2024
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Provider Practice Location Address
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    Address Line         |    1078 BLOOMFIELD AVE 
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    City                 |    AKRON
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    State                |    OH
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    Zip                  |    44302-1150
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    Country              |    US
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    Telephone            |    330-634-4265
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1078 BLOOMFIELD AVE 
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    City                 |    AKRON
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    State                |    OH
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    Zip                  |    44302-1150
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    Country              |    US
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    Telephone            |    330-634-4265
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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        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    
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    License Number State |    NULL
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Taxonomy #2
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    Taxonomy Code        |    374U00000X
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    Taxonomy Name        |    Home Health Aide
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    License Number       |    
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    License Number State |    OH
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Taxonomy #3
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    Taxonomy Code        |    376J00000X
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    Taxonomy Name        |    Homemaker
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    License Number       |    
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    License Number State |    OH
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Taxonomy #4
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    Taxonomy Code        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    
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    License Number State |    NULL
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