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NPI Code Detail

MEDICARE: REAGAN PAISLEY SMITH

MEDICARE: REAGAN PAISLEY SMITH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1194578484
Entity Type Code : Individual
Provider Name (Legal Business Name) : REAGAN PAISLEY SMITH
Provider Business Mailing Address
First Line : 16550 PARKER RD
Second Line :
City : ATHENS
State : AL
Zip : 35611-8538
Country : US
Telephone Number : 256-998-0670
Fax Number :
Provider Business Practice Location Address
First Line : 3966 ATLANTA HWY STE 375
Second Line :
City : MONTGOMERY
State : AL
Zip : 36109-2919
Country : US
Telephone Number : 185-583-2672
Fax Number : 772-675-9100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2024
Last Update Date : 04/08/2024

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Directions to “ REAGAN PAISLEY SMITH ” Practice Location

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