Individual ProviderMichelle Diane SmithBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address421 Fayetteville St, Raleigh, NC 27601-1792(910) 583-5814PECOS EnrollmentBased on the most recent information from CMS, provider Michelle Diane Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1730737883Provider TypeIndividualFull NameSmith, Michelle DianeGenderFemaleSole ProprietorNoEnumeration Date9/2/2019Last Updated9/2/2019Contact InformationPractice LocationPractice Address421 Fayetteville St, Raleigh, NC 27601-1792Phone(910) 583-5814FaxUnlisted FaxMailing LocationMailing Address421 Fayetteville St, Raleigh, NC 27601-1792Phone(910) 583-5814FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer