Provider Demographics
NPI:1467462556
Name:BEEZLEY-SMITH, DANA ANN (PHD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:ANN
Last Name:BEEZLEY-SMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4031 MASSILLON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7821
Mailing Address - Country:US
Mailing Address - Phone:330-899-9944
Mailing Address - Fax:330-899-9944
Practice Address - Street 1:4031 MASSILLON RD
Practice Address - Street 2:SUITE C
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7821
Practice Address - Country:US
Practice Address - Phone:330-899-9944
Practice Address - Fax:330-899-9944
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4405103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCP23712Medicare PIN