Healthcare Provider Details

I. General information

NPI: 1962339952
Provider Name (Legal Business Name): RYLEE SMITH M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RYLEE CARROLL

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 W MARKET ST STE 4
ATHENS AL
35611-2454
US

IV. Provider business mailing address

1005 W MARKET ST STE 4
ATHENS AL
35611-2454
US

V. Phone/Fax

Practice location:
  • Phone: 256-431-4223
  • Fax: 256-472-4300
Mailing address:
  • Phone: 256-431-4223
  • Fax: 256-472-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6063
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: