Provider Demographics
NPI:1679053144
Name:SMITH, ASHANTI NETANYA (BS)
Entity Type:Individual
Prefix:
First Name:ASHANTI
Middle Name:NETANYA
Last Name:SMITH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 EVERETT ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-3613
Mailing Address - Country:US
Mailing Address - Phone:337-794-6090
Mailing Address - Fax:
Practice Address - Street 1:1325 WRIGHT AVE STE D
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2226
Practice Address - Country:US
Practice Address - Phone:337-514-5181
Practice Address - Fax:337-514-5182
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator