MEDICARE: CHRISTOPHER MILLER 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

General Provider Information

NPI Number	:	1447990338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER MILLER SMITH

Provider Business Mailing Address
First Line	:	BEHAVIOR FRONTIERS, LLC 7375 WOODWARD AVE, SUITE 2800 D
Second Line	:
City	:	DETRIOT
State	:	MI
Zip	:	48202
Country	:	US
Telephone Number	:	888-922-2843
Fax Number	:	855-568-2494

Provider Business Practice Location Address
First Line	:	BEHAVIOR FRONTIERS, LLC 7375 WOODWARD AVE, SUITE 2800
Second Line	:
City	:	DETRIOT
State	:	MI
Zip	:	48202
Country	:	US
Telephone Number	:	888-922-2843
Fax Number	:	855-568-2494

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

Provider Enumeration Date	:	03/30/2022
Last Update Date	:	03/30/2022

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Directions to “ CHRISTOPHER MILLER SMITH ” Practice Location

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