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NPI Code Detail

MEDICARE: VICTORIA L SMITH LISW - SUPERVISOR

MEDICARE: VICTORIA L SMITH LISW - SUPERVISOR
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
1104100000XSocial WorkerI 0800260OH

General Provider Information

NPI Number : 1194962035
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA L SMITH LISW - SUPERVISOR
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-587-8092
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-4985
Country : US
Telephone Number : 216-587-8092
Fax Number : 216-587-8153
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2009
Last Update Date : 07/28/2020

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Directions to “ VICTORIA L SMITH LISW - SUPERVISOR” Practice Location

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