Provider Demographics
NPI:1417782392
Name:SMITH, KEIER RENAE
Entity type:Individual
Prefix:
First Name:KEIER
Middle Name:RENAE
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 1:2400 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2191
Mailing Address - Country:US
Mailing Address - Phone:412-383-1575
Mailing Address - Fax:
Practice Address - Street 1:2400 E CARSON ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2191
Practice Address - Country:US
Practice Address - Phone:412-383-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician