MEDICARE: CHRISTY SHEPHERD 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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1578881231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY SHEPHERD SMITH

Provider Business Mailing Address
First Line	:	9501 MOUNT AYRE WAY
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-7836
Country	:	US
Telephone Number	:	615-691-0394
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 MOUNT AYRE WAY
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37129-7836
Country	:	US
Telephone Number	:	615-691-0394
Fax Number	:

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

Provider Enumeration Date	:	05/05/2010
Last Update Date	:	05/05/2010

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Directions to “ CHRISTY SHEPHERD SMITH ” Practice Location

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