Doctor Name: | JERRY NEIL SMITH |
NPI Number: | 1356545669 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2082 |
Business Practice Address: | 210 W Lakeview Dr Trenton, NC - 285859589 |
Business Phone Number: | 2524481099 |
Business Fax Number: | |
Mailing Address: | Po Box 445, TRENTON |
State: | NC |
Postal Code: | 285850445 |
Phone Number: | 2524481099 |
Fax Number: | |
NPI Enumeration Date: | 06/12/2007 |
NPI Last Update Date: | 06/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2082 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
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 |