Provider Demographics
NPI:1215132113
Name:ALL ABOUT LIFE
Entity type:Organization
Organization Name:ALL ABOUT LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PC
Authorized Official - Phone:724-699-8818
Mailing Address - Street 1:4056 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3403
Mailing Address - Country:US
Mailing Address - Phone:724-699-8818
Mailing Address - Fax:724-981-3372
Practice Address - Street 1:4056 E STATE ST
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3403
Practice Address - Country:US
Practice Address - Phone:724-699-8818
Practice Address - Fax:724-981-3372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004398101YP2500X
OHE0004297101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty