Individual
MARIAH ROSE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1835 MIRACLE MILE, SPRINGFIELD, OH 45503-2807
(937) 561-3016
Mailing address
1835 MIRACLE MILE, SPRINGFIELD, OH 45503-2807
(937) 561-3016
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
UQ301614
OH
253Z00000X
In Home Supportive Care Agency
UQ301614
OH
3747P1801X
Personal Care Attendant
UQ301614
OH
376J00000X
Homemaker
Primary
UQ301614
OH
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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