Doctor Name: | MRS. TRACEY K SMITH |
NPI Number: | 1124395231 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MACCC-SLP |
License Number: | 12016699 |
Business Practice Address: | 3604 Clarkston Rd Clarkston, MI - 483485215 |
Business Phone Number: | 2488149300 |
Business Fax Number: | |
Mailing Address: | 11294 Forestview Ct, WASHINGTON |
State: | MI |
Postal Code: | 480943779 |
Phone Number: | 5869929950 |
Fax Number: | |
NPI Enumeration Date: | 11/18/2011 |
NPI Last Update Date: | 11/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12016699 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |