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
Fax: (602) 629-6504
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235276205 NPPES
Arizona MEDICAID 581456

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