Provider Demographics
NPI:1124839576
Name:SMITH, AHNIAH S
Entity type:Individual
Prefix:
First Name:AHNIAH
Middle Name:S
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 1:2000 E WESTMORELAND ST UNIT 303
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-3361
Mailing Address - Country:US
Mailing Address - Phone:267-939-0598
Mailing Address - Fax:
Practice Address - Street 1:2000 E WESTMORELAND ST UNIT 303
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-3361
Practice Address - Country:US
Practice Address - Phone:267-939-0598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst