MEDICARE: TARAH SMITH

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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1184555278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARAH SMITH

Provider Business Mailing Address
First Line	:	N4134 S BARTONS RD
Second Line	:
City	:	OAKFIELD
State	:	WI
Zip	:	53065-9790
Country	:	US
Telephone Number	:	920-517-7986
Fax Number	:

Provider Business Practice Location Address
First Line	:	327 N FOND DU LAC AVE
Second Line	:
City	:	CAMPBELLSPORT
State	:	WI
Zip	:	53010-3521
Country	:	US
Telephone Number	:	920-533-8381
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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Directions to “ TARAH SMITH ” Practice Location

Language	Start Address	Practice Location

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