Provider Demographics
NPI:1073078424
Name:SMITH, ADRIENNE HEDGES
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:HEDGES
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 1:10325 FIRE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-1378
Mailing Address - Country:US
Mailing Address - Phone:432-638-5091
Mailing Address - Fax:
Practice Address - Street 1:10325 FIRE RIDGE DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1378
Practice Address - Country:US
Practice Address - Phone:432-638-5091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16289235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist