Provider Demographics
NPI:1821363169
Name:SMITH, MICHELLE AMBER (CPD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:AMBER
Last Name:SMITH
Suffix:
Gender:F
Credentials:CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 CORBIN AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3007
Mailing Address - Country:US
Mailing Address - Phone:818-263-4288
Mailing Address - Fax:
Practice Address - Street 1:7301 CORBIN AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3007
Practice Address - Country:US
Practice Address - Phone:818-263-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula