Individual
JERMAIN M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BEHAVIOR ANALYST
Contact information
Practice address
300 W SWANSON AVE, WASILLA, AK 99654-6844
(907) 357-0891
Mailing address
2088 S PADDOCK DR, WASILLA, AK 99654-8467
(907) 203-1601
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-49303
—
106S00000X
Behavior Technician
RBT-18-67793
—
Other
Enumeration date
10/13/2018
Last updated
04/19/2021
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