Provider Demographics
NPI:1790254050
Name:BUTLER-SMITH, MONICA LYNN
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNN
Last Name:BUTLER-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 1:2008 RANCH HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3807
Mailing Address - Country:US
Mailing Address - Phone:702-806-8485
Mailing Address - Fax:
Practice Address - Street 1:2008 RANCH HOUSE RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-3807
Practice Address - Country:US
Practice Address - Phone:702-806-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health