Provider Demographics
NPI:1033540109
Name:SMITH, JOSHUA NATHANIEL (MA/CF-SLP)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:NATHANIEL
Last Name:SMITH
Suffix:
Gender:M
Credentials:MA/CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6644 RUSH ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-5181
Mailing Address - Country:US
Mailing Address - Phone:614-370-4250
Mailing Address - Fax:
Practice Address - Street 1:1498 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-2454
Practice Address - Country:US
Practice Address - Phone:937-548-2317
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH146N00000X
OH2014046235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic