Doctor Name: | CASSANDRA EDMONSON SMITH |
NPI Number: | 1073827184 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 4704114673 |
Business Practice Address: | 13101 Allen Rd Southgate, MI - 481952216 |
Business Phone Number: | 7347857700 |
Business Fax Number: | |
Mailing Address: | 15361 Piedmont St, DETROIT |
State: | MI |
Postal Code: | 482231714 |
Phone Number: | 3135859876 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2010 |
NPI Last Update Date: | 07/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 4704114673 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |