Provider Demographics
NPI:1447779491
Name:SMITH, CACHE RENNA
Entity type:Individual
Prefix:
First Name:CACHE
Middle Name:RENNA
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 1:500 PERSIMMON TREE LN APT 122
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-2133
Mailing Address - Country:US
Mailing Address - Phone:302-312-1133
Mailing Address - Fax:
Practice Address - Street 1:500 PERSIMMON TREE LN APT 122
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-2133
Practice Address - Country:US
Practice Address - Phone:302-312-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician