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NPI Code Detail

MEDICARE: MYA CLAIRE SMITH

MEDICARE: MYA CLAIRE 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

General Provider Information

NPI Number : 1780425413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYA CLAIRE SMITH
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8832 SYRACUSE AVE
Second Line :
City : ANAHEIM
State : CA
Zip : 92804-6229
Country : US
Telephone Number : 323-916-4602
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2024
Last Update Date : 06/28/2024

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Directions to “ MYA CLAIRE SMITH ” Practice Location

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