Individual
TAMIKA SHAYVONNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S
Contact information
Practice address
1600 NW 128TH DR, APT. 208, SUNRISE, FL 33323-5216
(954) 636-8801
Mailing address
1600 NW 128TH DR, APT. 208, SUNRISE, FL 33323-5202
(954) 636-8801
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
SA 10980
FL
Other
Enumeration date
06/15/2010
Last updated
04/01/2015
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