MEDICARE: J'TERICA 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
1	106S00000X	Behavior Technician
2	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1316687585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	J'TERICA SMITH

Provider Business Mailing Address
First Line	:	2016 LEICHESTER LN
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-6960
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 ROBIN HOOD LN
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38111-5343
Country	:	US
Telephone Number	:	901-591-5017
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2022
Last Update Date	:	07/22/2025

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Directions to “ J'TERICA SMITH ” Practice Location

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