Individual
MR. KEVIN ETWOOD SMITH JR.
Active
Individual
MR. KEVIN ETWOOD SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
AZ
261QA0600X
Adult Day Care Clinic/Center
—
AZ
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
AZ
310400000X
Assisted Living Facility
—
AZ
Other
Enumeration date
06/21/2024
Last updated
08/05/2025
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