Provider Demographics
NPI:1770136624
Name:SMITH, ASHLEE DAWN (LMT)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:DAWN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:ASHLEE
Other - Middle Name:DAWN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:5451 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-8844
Mailing Address - Country:US
Mailing Address - Phone:501-215-0784
Mailing Address - Fax:
Practice Address - Street 1:15424 ARCH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-5434
Practice Address - Country:US
Practice Address - Phone:501-261-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR8450225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist