Provider Demographics
NPI:1568032035
Name:SMITH, KASSIE RHEA (MA, LBA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:KASSIE
Middle Name:RHEA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, LBA, BCBA
Other - Prefix:
Other - First Name:KASSIE
Other - Middle Name:RHEA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 RSCR 3200
Mailing Address - Street 2:
Mailing Address - City:EMORY
Mailing Address - State:TX
Mailing Address - Zip Code:75440-4272
Mailing Address - Country:US
Mailing Address - Phone:903-269-8485
Mailing Address - Fax:
Practice Address - Street 1:210 RSCR 3200
Practice Address - Street 2:
Practice Address - City:EMORY
Practice Address - State:TX
Practice Address - Zip Code:75440-4272
Practice Address - Country:US
Practice Address - Phone:903-269-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4153103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst