Doctor Name: | MRS. KATIE LYNNE SMITH |
NPI Number: | 1154730497 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | SA12384 |
Business Practice Address: | 701 Victoria St Brandon, FL - 335104100 |
Business Phone Number: | 8136814220 |
Business Fax Number: | |
Mailing Address: | 3204 Hurley Grove Way, VALRICO |
State: | FL |
Postal Code: | 33596 |
Phone Number: | 8138102369 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2014 |
NPI Last Update Date: | 08/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA12384 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |