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General NPI Number Information
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NPI Number | 1801677190
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Entity Type | Individual
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Provider Name | MRS. BROOKE SMITH
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Gender | Female
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 1517 E BARRINGER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19150-3301
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Country | US
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Telephone | 267-688-4793
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Fax |
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Provider Business Mailing Address
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Address Line | 1517 E BARRINGER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19150-3301
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Country | US
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Telephone | 267-688-4793
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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 | 374J00000X
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Taxonomy Name | Doula
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License Number | 19783
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number | 2295
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MSG014494
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License Number State | PA
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