Provider Demographics
NPI:1003079351
Name:SMITH, DARIA
Entity Type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 SIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1324
Mailing Address - Country:US
Mailing Address - Phone:919-538-5609
Mailing Address - Fax:
Practice Address - Street 1:30 4TH AVENUE
Practice Address - Street 2:SUITE G
Practice Address - City:CURWENSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16833
Practice Address - Country:US
Practice Address - Phone:814-236-0600
Practice Address - Fax:814-236-3809
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007692235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist