Doctor Name: | MR. RANDY WAYNE SMITH |
NPI Number: | 1922371483 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCC-SLP |
License Number: | SP-210 |
Business Practice Address: | 3000 Martineau Pl North Little Rock, AR - 721168547 |
Business Phone Number: | 5018124157 |
Business Fax Number: | |
Mailing Address: | 3000 Martineau Pl, NORTH LITTLE ROCK |
State: | AR |
Postal Code: | 721168547 |
Phone Number: | 5018310519 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2012 |
NPI Last Update Date: | 02/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP-210 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
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 |