Individual
IDA O SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4023 KENNETT PIKE # 988, WILMINGTON, DE 19807-2018
(484) 577-9928
Mailing address
330 BARBARA DR, CLARKSBORO, NJ 08020-1508
(856) 981-8361
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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