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NPI Code Detail

MEDICARE: JALA LATRICE NICOLE SMITH

MEDICARE: JALA LATRICE NICOLE 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1952071367
Entity Type Code : Individual
Provider Name (Legal Business Name) : JALA LATRICE NICOLE SMITH
Provider Business Mailing Address
First Line : 18899 N THOMPSON PEAK PKWY STE 100
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85255-6335
Country : US
Telephone Number : 480-999-6199
Fax Number :
Provider Business Practice Location Address
First Line : 7236 S CENTRAL AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85042-5425
Country : US
Telephone Number : 602-240-3074
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2021
Last Update Date : 03/26/2026

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Directions to “ JALA LATRICE NICOLE SMITH ” Practice Location

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