Individual
FREDDIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8101 W LAMAR RD APT 44, GLENDALE, AZ 85303-2721
(602) 425-3188
Mailing address
8101 W LAMAR RD APT 44, GLENDALE, AZ 85303-2721
(602) 425-3188
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171W00000X
Contractor
—
—
251B00000X
Case Management Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
02/21/2023
Last updated
03/02/2023
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