Provider Demographics
NPI:1922789114
Name:SMITH, HASHONDRA JERNIGAN (LIFE COACH)
Entity Type:Individual
Prefix:
First Name:HASHONDRA
Middle Name:JERNIGAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LIFE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 ABBINGTON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31523-8278
Mailing Address - Country:US
Mailing Address - Phone:912-270-9511
Mailing Address - Fax:
Practice Address - Street 1:1103 ABBINGTON WOODS DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31523-8278
Practice Address - Country:US
Practice Address - Phone:912-270-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAZMPKE2BHUO171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach