Provider Demographics
NPI:1194012476
Name:SMITH, TERRI J (HHA)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 SPRINGBROOK DR.
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224
Mailing Address - Country:US
Mailing Address - Phone:513-289-3924
Mailing Address - Fax:
Practice Address - Street 1:1028 SPRINGBROOK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1658
Practice Address - Country:US
Practice Address - Phone:513-289-3924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400795240808376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide