Provider Demographics
NPI:1952702649
Name:SMITH, AUTUMN
Entity Type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:SMITH
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 1:727 SMOKEY WOOD DR
Mailing Address - Street 2:
Mailing Address - City:SWISSVALE
Mailing Address - State:PA
Mailing Address - Zip Code:15218-2734
Mailing Address - Country:US
Mailing Address - Phone:412-657-9806
Mailing Address - Fax:
Practice Address - Street 1:727 SMOKEY WOOD DR
Practice Address - Street 2:
Practice Address - City:SWISSVALE
Practice Address - State:PA
Practice Address - Zip Code:15218-2734
Practice Address - Country:US
Practice Address - Phone:412-657-9806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor