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General NPI Number Information
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NPI Number | 1467745471
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Entity Type | Individual
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Provider Name | MRS. SHELLEY HUCKABEE SMITH
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Gender | Female
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 2708 NE 14TH ST SUITE 5
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City | POMPANO BEACH
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State | FL
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Zip | 33062-3565
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Country | US
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Telephone | 954-603-7885
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Fax | 954-342-0273
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Provider Business Mailing Address
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Address Line | 3240 LYNN RIDGE DR APT 2H
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City | RALEIGH
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State | NC
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Zip | 27613-8936
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Country | US
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Telephone | 910-340-1899
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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