MEDICARE: MISS EMILY LAUREN 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	122331	TX

General Provider Information

NPI Number	:	1548932874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS EMILY LAUREN SMITH

Provider Business Mailing Address
First Line	:	10301 RANCH ROAD 2222 APT 1614
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78730-1252
Country	:	US
Telephone Number	:	830-708-4692
Fax Number	:	210-571-1704

Provider Business Practice Location Address
First Line	:	10301 RANCH ROAD 2222 APT 1614
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78730-1252
Country	:	US
Telephone Number	:	830-708-4692
Fax Number	:	210-571-1704

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

Provider Enumeration Date	:	10/05/2021
Last Update Date	:	05/28/2026

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Directions to “ MISS EMILY LAUREN SMITH ” Practice Location

Language	Start Address	Practice Location

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