Individual
ILYSIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
5328 W MARKET ST APT 17G, GREENSBORO, NC 27409-4219
(336) 549-1248
Mailing address
5328 W MARKET ST APT 17G, GREENSBORO, NC 27409-4219
(336) 549-1248
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
25-436569
NC
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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