Provider Demographics
NPI:1801491931
Name:SMALLWOOD, EMILY MARIE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:SMALLWOOD
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 1:89 YANKEE CT
Mailing Address - Street 2:
Mailing Address - City:HEDGESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25427-5020
Mailing Address - Country:US
Mailing Address - Phone:724-290-3173
Mailing Address - Fax:
Practice Address - Street 1:89 YANKEE CT
Practice Address - Street 2:
Practice Address - City:HEDGESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25427-5020
Practice Address - Country:US
Practice Address - Phone:724-290-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant