Individual
MS. IMANI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2212 DITMAS AVE, APT #6E, BROOKLYN, NY 11226-6965
(347) 679-5803
Mailing address
2212 DITMAS AVE, APT #6E, BROOKLYN, NY 11226-6965
(347) 679-5803
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16040296400
—
NY
Enumeration date
06/03/2016
Last updated
06/03/2016
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