Provider Demographics
NPI:1760728828
Name:SMITH, RISHEE SHAWNELLE
Entity Type:Individual
Prefix:
First Name:RISHEE
Middle Name:SHAWNELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 BEACON BAY CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-8184
Mailing Address - Country:US
Mailing Address - Phone:407-814-4698
Mailing Address - Fax:
Practice Address - Street 1:1350 ORANGE AVE STE 200
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4955
Practice Address - Country:US
Practice Address - Phone:407-644-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health