Provider Demographics
NPI:1588474183
Name:SMITH, MAGGIE C
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:C
Last Name:SMITH
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 1:1023 HARBOUR LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40342-8544
Mailing Address - Country:US
Mailing Address - Phone:859-948-1492
Mailing Address - Fax:
Practice Address - Street 1:2956 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-9141
Practice Address - Country:US
Practice Address - Phone:859-537-5367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist