Provider Demographics
NPI:1487961660
Name:SMILEY, MYSHANIKI LASHAWNTE
Entity type:Individual
Prefix:
First Name:MYSHANIKI
Middle Name:LASHAWNTE
Last Name:SMILEY
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 1:1555 BALZAR AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-2149
Mailing Address - Country:US
Mailing Address - Phone:702-336-8265
Mailing Address - Fax:
Practice Address - Street 1:1555 BALZAR AVE APT 208
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-2149
Practice Address - Country:US
Practice Address - Phone:702-336-8265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker