Healthcare Provider Details

I. General information

NPI: 1427688043
Provider Name (Legal Business Name): CORINNE SMYK SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 136TH AVE
HOLLAND MI
49424-7483
US

IV. Provider business mailing address

3200 152ND AVE
HOLLAND MI
49424-5902
US

V. Phone/Fax

Practice location:
  • Phone: 616-786-1200
  • Fax:
Mailing address:
  • Phone: 616-786-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101006518
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: