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Individual

MCKENZIE NICOLE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
810 SHONEY DR SW STE 115, HUNTSVILLE, AL 35801-5450
(931) 993-2249
Mailing address
189 OLD BAPTIST RD, ARDMORE, TN 38449-3022
(931) 993-2249

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
134407425
TN

Other

Enumeration date
09/28/2021
Last updated
09/28/2021
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