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General NPI Number Information
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NPI Number | 1942931035
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Entity Type | Individual
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Provider Name | MARIA SMALL
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Gender | Female
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Dates
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Enumeration Date | 06/21/2022
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 454 W PIPKIN RD
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City | LAKELAND
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State | FL
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Zip | 33813-2545
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Country | US
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Telephone | 330-432-8449
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Fax |
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Provider Business Mailing Address
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Address Line | 120 SCOTT ST
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City | UHRICHSVILLE
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State | OH
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Zip | 44683-1738
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Country | US
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Telephone | 330-432-8449
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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