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NPI Code Detail

MEDICARE: MRS. DEBRA ANN SMITH MA, CCC-SLP

MEDICARE: MRS. DEBRA ANN SMITH MA, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist4191TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487721577
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBRA ANN SMITH MA, CCC-SLP
Provider Business Mailing Address
First Line : 9047 EXECUTIVE PARK DR
Second Line : SUITE 115
City : KNOXVILLE
State : TN
Zip : 37923-4605
Country : US
Telephone Number : 865-539-1928
Fax Number : 865-539-6461
Provider Business Practice Location Address
First Line : 9047 EXECUTIVE PARK DR
Second Line : SUITE 115
City : KNOXVILLE
State : TN
Zip : 37923-4605
Country : US
Telephone Number : 865-539-1928
Fax Number : 865-539-6461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 02/25/2010

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Directions to “ MRS. DEBRA ANN SMITH MA, CCC-SLP” Practice Location

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