Provider Demographics
NPI:1902646912
Name:SMITH, DENALI K
Entity type:Individual
Prefix:
First Name:DENALI
Middle Name:K
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 1:3170 SALEM RD
Mailing Address - Street 2:
Mailing Address - City:PARROTTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37843-2208
Mailing Address - Country:US
Mailing Address - Phone:208-670-7954
Mailing Address - Fax:
Practice Address - Street 1:400 KENDALL RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6803
Practice Address - Country:US
Practice Address - Phone:865-686-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health