Provider Demographics
NPI:1477288256
Name:NESMITH, DAMARA
Entity Type:Individual
Prefix:
First Name:DAMARA
Middle Name:
Last Name:NESMITH
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 1:1 CLEMENTINE CT APT 1D
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-6889
Mailing Address - Country:US
Mailing Address - Phone:443-901-8669
Mailing Address - Fax:
Practice Address - Street 1:1 CLEMENTINE CT APT 1D
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-6889
Practice Address - Country:US
Practice Address - Phone:443-901-8669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28449104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker