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Individual

KYLENE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MED

Contact information

Practice address
1010 N HANCOCK ST, PHILADELPHIA, PA 19123-2334
(267) 248-5174
Mailing address
1801 LAUREL RD UNIT 201, LINDENWOLD, NJ 08021-6731
(267) 248-5174

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/01/2021
Last updated
12/01/2021
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