Provider Demographics
NPI:1164803045
Name:SMOLASH, RUTH (MC, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:SMOLASH
Suffix:
Gender:F
Credentials:MC, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-2402
Mailing Address - Country:US
Mailing Address - Phone:781-307-7462
Mailing Address - Fax:
Practice Address - Street 1:534 SUMMER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-2402
Practice Address - Country:US
Practice Address - Phone:781-307-7462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4815235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA$$$$$$$$$OtherBCBS MA