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General NPI Number Information
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NPI Number | 1295539815
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Entity Type | Individual
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Provider Name | BREIANNA SMITH M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 1011 ABUTMENT RD STE 112
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City | DALTON
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State | GA
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Zip | 30721-4660
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Country | US
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Telephone | 706-252-8660
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Fax |
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Provider Business Mailing Address
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Address Line | 201 WILDER RD
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City | CHICKAMAUGA
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State | GA
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Zip | 30707-1736
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Country | US
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Telephone |
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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 | SLP011666
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License Number State | GA
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