Individual
DEJA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3623 CALVIN DR, COLUMBUS, GA 31904-7915
(706) 940-5100
Mailing address
7008 DEERWOOD LN, COLUMBUS, GA 31829-2755
(762) 822-1055
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-19-82920
GA
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/03/2019
Last updated
02/04/2025
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