Provider Demographics
NPI:1811244114
Name:SMITH, LASHONDA D (MS)
Entity type:Individual
Prefix:
First Name:LASHONDA
Middle Name:D
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 236063
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32923-6063
Mailing Address - Country:US
Mailing Address - Phone:909-327-7752
Mailing Address - Fax:
Practice Address - Street 1:1031 FAIRLAWN DR
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3031
Practice Address - Country:US
Practice Address - Phone:909-327-7752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor