Healthcare Provider Details

I. General information

NPI: 1295610996
Provider Name (Legal Business Name): ANNA CAMILLE SMITH M.S., CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 W CHESTNUT ST
ROGERS AR
72756-0351
US

IV. Provider business mailing address

8 S SECHREST CIR
ROGERS AR
72758-1405
US

V. Phone/Fax

Practice location:
  • Phone: 479-246-0101
  • Fax:
Mailing address:
  • Phone: 479-321-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number203278
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: