Individual
MS. TASHA CAROL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6947 CEDARPARK AVENUE, PHIADELPHIA, PA 19138
(215) 276-1073
Mailing address
6947 CEDAR PARK AVE, PHILADELPHIA, PA 19138-2001
(215) 276-1073
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN254827L
PA
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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