Provider Demographics
NPI:1629423660
Name:SMITH, ALANA (MA)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11050 N KENDALL DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1236
Mailing Address - Country:US
Mailing Address - Phone:786-332-4478
Mailing Address - Fax:305-503-9353
Practice Address - Street 1:11050 N KENDALL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1236
Practice Address - Country:US
Practice Address - Phone:786-332-4478
Practice Address - Fax:305-503-9353
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS1186103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool