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General NPI Number Information
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NPI Number | 1659894731
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN SMITH
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Gender | Female
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Dates
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Enumeration Date | 07/20/2017
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 908 NY36
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City | TROUPSBURG
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State | NY
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Zip | 14885
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Country | US
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Telephone | 607-525-6301
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Fax |
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Provider Business Mailing Address
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Address Line | 8586 STEVENS ROAD
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City | LINDLEY
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State | NY
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Zip | 14858-9795
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Country | US
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Telephone | 607-329-6973
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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 | 026808
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License Number State | NY
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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 | 026808-01
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License Number State | NY
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