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Individual

DEANDRA SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RBT

Contact information

Practice address
111 BULIFANTS BLVD STE B, WILLIAMSBURG, VA 23188
(757) 645-3860
Mailing address
763 J CLYDE MORRIS BLVD STE 1C, NEWPORT NEWS, VA 23601-1533
(434) 806-6281

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-16-26722
VA
106S00000X
Behavior Technician
222Q00000X
Developmental Therapist
T62056286
VA

Other

Enumeration date
08/13/2014
Last updated
05/11/2022
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