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General NPI Number Information
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NPI Number | 1144798224
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Entity Type | Individual
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Provider Name | THERESA RENE SMITH
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Gender | Female
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 2025 KEMPSVILLE RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-6805
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Country | US
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Telephone | 757-648-3840
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Fax |
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Provider Business Mailing Address
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Address Line | 14702 DAWN VALE DR
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City | HOUSTON
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State | TX
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Zip | 77062-2106
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Country | US
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Telephone | 713-560-3793
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 35605
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 115663
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 172386
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License Number State | AK
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202009090
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License Number State | VA
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