Provider Demographics
NPI:1417660846
Name:SMITHERS, LACEY (BCBA)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:SMITHERS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11919 RADURA RD
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4854
Mailing Address - Country:US
Mailing Address - Phone:832-596-5051
Mailing Address - Fax:
Practice Address - Street 1:11919 RADURA RD
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4854
Practice Address - Country:US
Practice Address - Phone:832-596-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst