Provider Demographics
NPI:1649154386
Name:SMITH, LYDIA B (MA)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:B
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 SPRING RD NW APT 301
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1214
Mailing Address - Country:US
Mailing Address - Phone:781-850-6592
Mailing Address - Fax:
Practice Address - Street 1:4405 E WEST HWY STE 410
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4535
Practice Address - Country:US
Practice Address - Phone:240-565-4231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty