Provider Demographics
NPI:1891539151
Name:SMITH, CARA
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
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 1:9080 MILLSTREAM CIR
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-3231
Mailing Address - Country:US
Mailing Address - Phone:330-554-2008
Mailing Address - Fax:
Practice Address - Street 1:20500 BELSHAW AVE # EXCA1377
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3506
Practice Address - Country:US
Practice Address - Phone:330-554-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach