Individual
MR. DERRICK SMILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
1028 FOXCROFT LANE, ESSEX, MD 21221
(571) 435-6973
Mailing address
1028 FOXCROFT LANE, ESSEX, MD 21221
(571) 435-6973
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
A00070221
MD
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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