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NPI Code Detail

MEDICARE: ASHLEY NICOLE SMITH

MEDICARE: ASHLEY NICOLE 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
1106E00000XAssistant Behavior Analyst
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1396228813
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY NICOLE SMITH
Provider Business Mailing Address
First Line : 6023 LIVERPOOL LN
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22315-4718
Country : US
Telephone Number : 703-867-7431
Fax Number :
Provider Business Practice Location Address
First Line : 12410 MILESTONE CENTER DR STE 600
Second Line :
City : GERMANTOWN
State : MD
Zip : 20876-7102
Country : US
Telephone Number : 410-874-5215
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2018
Last Update Date : 05/23/2024

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Directions to “ ASHLEY NICOLE SMITH ” Practice Location

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