Provider Demographics
NPI:1750144937
Name:SMITH, DAIJAH MARIE (CD, CPSW, MHFA, CHW)
Entity type:Individual
Prefix:
First Name:DAIJAH
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:CD, CPSW, MHFA, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 OSUNA RD NE APT 1014
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2291
Mailing Address - Country:US
Mailing Address - Phone:505-572-5652
Mailing Address - Fax:
Practice Address - Street 1:300 CENTRAL AVE SW STE 1500E
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3293
Practice Address - Country:US
Practice Address - Phone:505-369-1731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM175T00000X, 172V00000X, 175T00000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker
No374J00000XNursing Service Related ProvidersDoula