Provider Demographics
NPI:1093953796
Name:SMART, JENNIFER
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:SMART
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:TOWSON UNIVERSITY SLH CLINIC
Mailing Address - Street 2:8000 YORK ROAD
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21252-0001
Mailing Address - Country:US
Mailing Address - Phone:410-704-3095
Mailing Address - Fax:
Practice Address - Street 1:TOWSON UNIVERSITY SLH CLINIC
Practice Address - Street 2:8000 YORK ROAD
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21252-0001
Practice Address - Country:US
Practice Address - Phone:410-704-3095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01164231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist