Smith, Nicole

Smith, Nicole is an individual health care provider with primary practice located at 4620 N State Road 7 Ste 300 , Lauderdale Lakes FL 33319-5867. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Smith, Nicole can be contacted via phone (561) 903-1995.

Contact Information

Primary practice address
4620 N State Road 7 Ste 300 Lauderdale Lakes FL 33319-5867
Phone: (561) 903-1995
Fax: (561) 997-1246
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X R400625929040 Florida
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X Florida

Profile Details

NPI number 1336684992
LBN Legal business name Smith, Nicole
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2017
Last updated Nov 7th, 2024 - about 2 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 1336684992 NPPES
Florida MEDICAID 003810000

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