Individual
LISA WHYEYEH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6143 186TH ST STE 436, FRESH MEADOWS, NY 11365-2710
(929) 200-7105
Mailing address
7 NAVY PIER CT UNIT 3050, STATEN ISLAND, NY 10304-5425
(347) 944-2294
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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