Provider Demographics
NPI:1801567318
Name:SMILEY, LATASHA (QBHS)
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:
Last Name:SMILEY
Suffix:
Gender:F
Credentials:QBHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27801 EUCLID AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3547
Mailing Address - Country:US
Mailing Address - Phone:216-417-1007
Mailing Address - Fax:216-803-2022
Practice Address - Street 1:27801 EUCLID AVE STE 300
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3547
Practice Address - Country:US
Practice Address - Phone:216-417-1007
Practice Address - Fax:216-803-2022
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker