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NPI Code Detail

MEDICARE: MAGGIE MAE SMIDT

MEDICARE:   MAGGIE MAE SMIDT
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1851020515
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAGGIE MAE SMIDT
Provider Business Mailing Address
First Line : 901 N SANTA FE AVE
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1738
Country : US
Telephone Number : 719-822-0550
Fax Number :
Provider Business Practice Location Address
First Line : 901 N SANTA FE AVE
Second Line :
City : FOUNTAIN
State : CO
Zip : 80817-1738
Country : US
Telephone Number : 719-822-0550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2022
Last Update Date : 01/30/2026

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Directions to “ MAGGIE MAE SMIDT ” Practice Location

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