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NPI Code Detail

MEDICARE: CECILY RENE SMITH MS

MEDICARE: CECILY RENE SMITH MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistIN

General Provider Information

NPI Number : 1134855091
Entity Type Code : Individual
Provider Name (Legal Business Name) : CECILY RENE SMITH MS
Provider Business Mailing Address
First Line : 14517 TWIN OAKS DR
Second Line :
City : CARMEL
State : IN
Zip : 46032-9727
Country : US
Telephone Number : 317-670-4642
Fax Number :
Provider Business Practice Location Address
First Line : 2303 PHIL WARD BLVD
Second Line :
City : CRAWFORDSVILLE
State : IN
Zip : 47933-4607
Country : US
Telephone Number : 317-520-4748
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2022
Last Update Date : 07/25/2022

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Directions to “ CECILY RENE SMITH MS” Practice Location

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