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General NPI Number Information
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NPI Number | 1467245514
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Entity Type | Individual
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Provider Name | ALEXIS TAYLOR SMITH N/A
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Gender | Female
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 506 N MAIN ST
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City | HINESVILLE
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State | GA
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Zip | 31313-2512
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Country | US
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Telephone | 615-560-6622
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Fax |
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Provider Business Mailing Address
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Address Line | 1227 GEORGE SMITH RD
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City | CLAXTON
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State | GA
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Zip | 30417-7622
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Country | US
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Telephone | 912-314-1688
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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 |
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License Number State | GA
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