Individual
ELLENA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3715 KADEY DR, CHARLOTTE, NC 28208-2290
(301) 640-0151
Mailing address
3715 KADEY DR, CHARLOTTE, NC 28208-2290
(301) 640-0151
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
374700000X
Technician
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
08/13/2015
Last updated
08/25/2015
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