Provider Demographics
NPI:1215784103
Name:SMITH, HALI MARIE
Entity type:Individual
Prefix:
First Name:HALI
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5436 HARRISON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64110-2509
Mailing Address - Country:US
Mailing Address - Phone:816-501-8220
Mailing Address - Fax:
Practice Address - Street 1:10842 MCGEE ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5018
Practice Address - Country:US
Practice Address - Phone:816-708-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician