Healthcare Provider Details

I. General information

NPI: 1245442102
Provider Name (Legal Business Name): WHITNEY A. SMITH M.ED, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1618 GUNBARREL RD STE 102
CHATTANOOGA TN
37421-4139
US

IV. Provider business mailing address

1618 GUNBARREL RD STE 102
CHATTANOOGA TN
37421-4139
US

V. Phone/Fax

Practice location:
  • Phone: 423-774-7775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA0000001326
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0000001326
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: