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General NPI Number Information
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NPI Number | 1669792420
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Entity Type | Organization
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Legal Business Name | SHAYLA D. CRAYS SMITH, AUD, LTD
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 1406 WILLOWBROOK RD STE 106
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City | BELOIT
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State | WI
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Zip | 53511-6925
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Country | US
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Telephone | 608-364-4400
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Fax | 608-312-2477
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Provider Business Mailing Address
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Address Line | 1406 WILLOWBROOK RD STE 106
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City | BELOIT
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State | WI
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Zip | 53511-6925
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Country | US
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Telephone | 608-364-4400
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Fax | 608-312-2477
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHAYLA D.C. SMITH
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Credential |
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Telephone | 608-364-4400
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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 | 467-156
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License Number State | WI
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