Most Relevant Information
Provider Data
| NPI Number: | 1003551755 |
| Provider Name: | ANGELICA BREANA SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/27/2022 |
| Last Updated: | 04/27/2022 |
Provider Practice Location
6722 MALONE CREEK DR
KNOXVILLE
TN
379313402
Practice Location Phone/Fax
| Phone: | 8338255246 |
| Fax: |
Provider Mailing Location
6722 MALONE CREEK DR
KNOXVILLE
TN
379313402
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |