| Doctor Name: | MS. MARY MANDY SMITH |
| NPI Number: | 1629271960 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M. ED. CCC-SLP |
| License Number: | PCET001193 |
| Business Practice Address: | 11835 Alpharetta Hwy Roswell, GA - 300764929 |
| Business Phone Number: | 4047858500 |
| Business Fax Number: | |
| Mailing Address: | 5201 Center Hill Church Rd, LOGANVILLE |
| State: | GA |
| Postal Code: | 300527226 |
| Phone Number: | 4045136355 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2007 |
| NPI Last Update Date: | 01/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | PCET001193 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |