MEDICARE: BECCA 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	:	1275985467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BECCA SMITH

Provider Business Mailing Address
First Line	:	7541 MAGNOLIA HWY
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-8539
Country	:	US
Telephone Number	:	318-509-9211
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 LIBERTY ST
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4322
Country	:	US
Telephone Number	:	318-509-9211
Fax Number	:

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

Provider Enumeration Date	:	07/12/2016
Last Update Date	:	12/15/2025

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Directions to “ BECCA SMITH ” Practice Location

Language	Start Address	Practice Location

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