Provider Demographics
NPI:1639067184
Name:SMITH, DONNICA (QMHS)
Entity type:Individual
Prefix:
First Name:DONNICA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 PARKBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1837
Mailing Address - Country:US
Mailing Address - Phone:937-422-0249
Mailing Address - Fax:
Practice Address - Street 1:7813 N DIXIE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2719
Practice Address - Country:US
Practice Address - Phone:937-422-0249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health