Provider Demographics
NPI:1184918773
Name:SMITH, MARIBETH CIALLI (BS, IBCLC, RLC)
Entity type:Individual
Prefix:MRS
First Name:MARIBETH
Middle Name:CIALLI
Last Name:SMITH
Suffix:
Gender:F
Credentials:BS, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ST. JOSEPH PARKWAY
Mailing Address - Street 2:#324
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8701
Mailing Address - Country:US
Mailing Address - Phone:713-302-1591
Mailing Address - Fax:281-888-3166
Practice Address - Street 1:300 ST JOSEPH PKWY
Practice Address - Street 2:#324
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8598
Practice Address - Country:US
Practice Address - Phone:713-302-1591
Practice Address - Fax:281-888-3166
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198-15181174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN