Provider Demographics
NPI:1801191887
Name:D A SMITHYMAN, LLC
Entity Type:Organization
Organization Name:D A SMITHYMAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SMITHYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:479-200-6383
Mailing Address - Street 1:1601 RAINBOW RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8821
Mailing Address - Country:US
Mailing Address - Phone:479-254-1144
Mailing Address - Fax:479-254-1099
Practice Address - Street 1:1601 RAINBOW RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8821
Practice Address - Country:US
Practice Address - Phone:479-254-1144
Practice Address - Fax:479-254-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10-09P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1952307548OtherINDIVIDUAL NPI