MEDICARE: TEMEYKA 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	104100000X	Social Worker	LMSW 10575	SC

General Provider Information

NPI Number	:	1528455482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEMEYKA SMITH

Provider Business Mailing Address
First Line	:	117 LONG BAY CT
Second Line	:
City	:	GOOSE CREEK
State	:	SC
Zip	:	29445-7224
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	117 LONG BAY CT
Second Line	:
City	:	GOOSE CREEK
State	:	SC
Zip	:	29445-7224
Country	:	US
Telephone Number	:	678-953-1744
Fax Number	:

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

Provider Enumeration Date	:	04/17/2015
Last Update Date	:	04/17/2015

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Directions to “ TEMEYKA SMITH ” Practice Location

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