Individual
EBONY ETASHIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 GEORGE ST STE J, BECKLEY, WV 25801-2648
(304) 929-2670
Mailing address
111C MILLER BRAGG CIR, MOUNT HOPE, WV 25880-9467
(304) 362-2041
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
WV
Other
Enumeration date
10/01/2020
Last updated
10/01/2020
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