Provider Demographics
NPI:1821889221
Name:SMITH, L'TRENTIS D
Entity type:Individual
Prefix:
First Name:L'TRENTIS
Middle Name:D
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 1:214 S MAIN ST STE 218
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4768
Mailing Address - Country:US
Mailing Address - Phone:630-296-6645
Mailing Address - Fax:
Practice Address - Street 1:214 S MAIN ST STE 218
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4768
Practice Address - Country:US
Practice Address - Phone:630-296-6645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193376164X00000X
374J00000X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No164X00000XNursing Service ProvidersLicensed Vocational Nurse
No374J00000XNursing Service Related ProvidersDoula