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NPI Code Detail

MEDICARE: MRS. JACLYN MERRIMAN SMITH M.C.D., CCC-SLP

MEDICARE:  MRS. JACLYN MERRIMAN SMITH  M.C.D., 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 Pathologist2347AL

General Provider Information

NPI Number : 1922318401
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACLYN MERRIMAN SMITH M.C.D., CCC-SLP
Provider Business Mailing Address
First Line : 1050 LAKE COLONY LN
Second Line :
City : VESTAVIA
State : AL
Zip : 35242-7405
Country : US
Telephone Number : 205-531-8998
Fax Number : 205-970-4122
Provider Business Practice Location Address
First Line : 4229 DOLLY RIDGE RD
Second Line :
City : VESTAVIA
State : AL
Zip : 35243-5703
Country : US
Telephone Number : 205-531-8998
Fax Number : 205-970-4122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2010
Last Update Date : 10/18/2010

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Directions to “ MRS. JACLYN MERRIMAN SMITH M.C.D., CCC-SLP” Practice Location

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