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NPI Code Detail

MEDICARE: SAMANTHA SMITH

MEDICARE: SAMANTHA 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 : 1245172147
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA SMITH
Provider Business Mailing Address
First Line : 1653 CAMPUS PARK DR STE B
Second Line :
City : MONROE
State : NC
Zip : 28112-4048
Country : US
Telephone Number : 704-780-4271
Fax Number :
Provider Business Practice Location Address
First Line : 1653 CAMPUS PARK DR STE B
Second Line :
City : MONROE
State : NC
Zip : 28112-4048
Country : US
Telephone Number : 704-780-4271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ SAMANTHA SMITH ” Practice Location

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