Provider Demographics
NPI:1386973725
Name:SMITH- MILOW, LASHONDA N (MED)
Entity type:Individual
Prefix:MRS
First Name:LASHONDA
Middle Name:N
Last Name:SMITH- MILOW
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 CROSSBROOK LN
Mailing Address - Street 2:APT 8
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-4810
Mailing Address - Country:US
Mailing Address - Phone:601-218-7651
Mailing Address - Fax:901-388-7068
Practice Address - Street 1:7025 7TH RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-2567
Practice Address - Country:US
Practice Address - Phone:901-385-7463
Practice Address - Fax:901-388-7068
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness