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Individual

ANGELITE PAIGE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
719 SPENCER ST, LOGANSPORT, IN 46947-3583
(765) 242-8910
Mailing address
719 SPENCER ST, LOGANSPORT, IN 46947-3583
(765) 242-8910

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RBT-22-246617
BEHAVIOR ANALYST CERTIFICATION BOARD
IN
Enumeration date
12/15/2022
Last updated
12/15/2022
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