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General NPI Number Information
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NPI Number | 1326930017
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Entity Type | Individual
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Provider Name | ALYSHA MARIE SMITH
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Gender | Female
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 650 W NEW YORK AVE
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City | DELAND
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State | FL
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Zip | 32720-5239
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Country | US
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Telephone | 386-262-1907
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Fax |
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Provider Business Mailing Address
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Address Line | 267 N PREVATT AVE
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City | LAKE HELEN
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State | FL
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Zip | 32744-2502
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Country | US
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Telephone | 386-956-5833
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Fax | 386-956-5833
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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-25-5207-993764
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License Number State | FL
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