Provider Demographics
NPI:1992998462
Name:SMEDS, RHAINA A (PSYD)
Entity type:Individual
Prefix:DR
First Name:RHAINA
Middle Name:A
Last Name:SMEDS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 AVENUE A STE 2D
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4437
Mailing Address - Country:US
Mailing Address - Phone:772-485-4008
Mailing Address - Fax:772-334-0225
Practice Address - Street 1:100 AVENUE A STE 2D
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950
Practice Address - Country:US
Practice Address - Phone:772-485-4008
Practice Address - Fax:772-334-0225
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6704103TC0700X, 103TP2701X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy