Provider Information for 1710568381
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AYANA SMITH LCSW
Other Names:Other Name:Miss AYANA C SMITHSex: Female
NPI: 1710568381
Last Updated: 2021-04-15
Certification Date: 2021-04-15
Certification Date: 2021-04-15
Details
Name | Value | ||||||||||||||
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NPI | 1710568381 | ||||||||||||||
Enumeration Date | 2021-04-15 | ||||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||||
Sole Proprietor | YES | ||||||||||||||
Status | Active | ||||||||||||||
Mailing Address | 3505 INLET CIR GREENACRES, FL 33463-2315 United States Phone: | Fax: | ||||||||||||||
Primary Practice Address | 4720 N STATE ROAD 7 LAUDERDALE LAKES, FL 33319-5860 United States Phone: 954-606-0911 | Fax: | ||||||||||||||
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