| NPI | 1023557170 |
|---|---|
| Former Name | ERICNIESHA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: WA LW61040860) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 21703) |
| 251S00000X Community/Behavioral Health (Licence: WA SC60721786) | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2025-06-19 |