| Organization Name: | SMITH PEDIATRIC REHAB, LLC |
| NPI Number: | 1871812966 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESSA SMITH CROLEY (SPEECH LANGUAGE PATHOLOGIST/OWNER) |
| Mailing Address: | 137 Whitman Rd Munfordville |
| State: | KY US |
| Postal Code: | 427658228 |
| Phone Number: | 2702021825 |
| Fax Number: | 2705241269 |
| NPI Enumeration Date: | 05/27/2010 |
| NPI Last Update Date: | 05/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2115 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| 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 |