MEDICARE: CEASIRE MAE 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	:	1770448813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CEASIRE MAE SMITH

Provider Business Mailing Address
First Line	:	181 SAN PEDRO DR
Second Line	:
City	:	ALAMOGORDO
State	:	NM
Zip	:	88310-9560
Country	:	US
Telephone Number	:	575-437-2300
Fax Number	:	575-437-2300

Provider Business Practice Location Address
First Line	:	181 SAN PEDRO DR
Second Line	:
City	:	ALAMOGORDO
State	:	NM
Zip	:	88310-9560
Country	:	US
Telephone Number	:	575-437-2300
Fax Number	:	575-437-2300

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

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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Directions to “ CEASIRE MAE SMITH ” Practice Location

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