Provider Demographics
NPI:1679325484
Name:SMITH, ANTHONY ALLEN II
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ALLEN
Last Name:SMITH
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E SNODGRASS RD
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-9596
Mailing Address - Country:US
Mailing Address - Phone:937-903-7514
Mailing Address - Fax:
Practice Address - Street 1:160 E SNODGRASS RD
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-9596
Practice Address - Country:US
Practice Address - Phone:937-903-7514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health