Provider Demographics
NPI:1720771249
Name:SMITH, RISHAWN
Entity Type:Individual
Prefix:
First Name:RISHAWN
Middle Name:
Last Name: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 1:2701 NEABSCO COMMON PL APT 216
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6701
Mailing Address - Country:US
Mailing Address - Phone:904-655-8302
Mailing Address - Fax:
Practice Address - Street 1:2701 NEABSCO COMMON PL APT 216
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-6701
Practice Address - Country:US
Practice Address - Phone:904-655-8302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management