Smith, Eileen B
Smith, Eileen B is an sole proprietor health care provider with primary practice located at 4825 E Roosevelt St , Phoenix AZ 85008-5917. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Smith, Eileen B can be contacted via phone (602) 629-6500.Contact Information
Primary practice address
4825 E Roosevelt St
Phoenix AZ 85008-5917
Phone: (602) 629-6500
Fax: (602) 629-6504
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 103TS0200X | 103TS0200X | Arizona |
Profile Details
| NPI number | 1235276205 |
|---|---|
| LBN Legal business name | Smith, Eileen B |
| Credentials | EDD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235276205 | NPPES |
| Arizona | MEDICAID | 581456 |
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