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General NPI Number Information
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NPI Number | 1861215154
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Entity Type | Individual
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Provider Name | LATOYA NICOLE SMITH LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 9968 SW 224TH ST APT 306
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City | CUTLER BAY
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State | FL
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Zip | 33190-1596
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Country | US
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Telephone | 786-205-7264
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Fax |
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Provider Business Mailing Address
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Address Line | 18495 S DIXIE HWY STE 320
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City | CUTLER BAY
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State | FL
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Zip | 33157-6817
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Country | US
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Telephone | 786-205-7264
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW23634
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License Number State | FL
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