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General NPI Number Information
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NPI Number | 1538315510
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Entity Type | Individual
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Provider Name | AMY JO SMITH M.A.C.C.C.A.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 500 E SPRINGHILL DR
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City | TERRE HAUTE
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State | IN
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Zip | 47802-4439
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Country | US
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Telephone | 812-237-0099
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Fax | 812-237-0097
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Provider Business Mailing Address
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Address Line | 1833 N KINSER PIKE
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City | BLOOMINGTON
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State | IN
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Zip | 47404-1914
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Country | US
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Telephone | 128-222-8928
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Fax | 128-222-8948
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 23002649A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 17001441A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 17001269A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 03296
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 147.000594
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 23002476A
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License Number State | IN
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