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NPI Code Detail

MEDICARE: SAMARA SMITH CCC-SLP

MEDICARE: SAMARA SMITH 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 Pathologist

General Provider Information

NPI Number : 1942168901
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMARA SMITH CCC-SLP
Provider Business Mailing Address
First Line : 6929 S SOONER RD APT 20205
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73135-2685
Country : US
Telephone Number : 405-653-0179
Fax Number :
Provider Business Practice Location Address
First Line : 525 S SCHWARTZ AVE
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-5955
Country : US
Telephone Number : 505-609-2625
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2026
Last Update Date : 01/09/2026

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Directions to “ SAMARA SMITH CCC-SLP” Practice Location

Language Start Address Practice Location
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