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General NPI Number Information
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NPI Number | 1962329771
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Entity Type | Individual
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Provider Name | AL-NISA SMITH
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Gender | Female
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 206 SOUTHERN AVE
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City | RAEFORD
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State | NC
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Zip | 28376-3272
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Country | US
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Telephone | 910-565-0622
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Fax |
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Provider Business Mailing Address
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Address Line | 231 EUNICE DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-3247
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Country | US
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Telephone |
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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 | BACB1582691
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License Number State | NC
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