Provider Demographics
NPI:1003248337
Name:SMITH, SUNTIA
Entity Type:Individual
Prefix:
First Name:SUNTIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MARKET POINT DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5768
Mailing Address - Country:US
Mailing Address - Phone:864-444-3057
Mailing Address - Fax:864-751-9331
Practice Address - Street 1:33 MARKET POINT DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5768
Practice Address - Country:US
Practice Address - Phone:864-444-3057
Practice Address - Fax:864-751-9331
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2014-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical