Provider Demographics
NPI:1174411334
Name:HEWETT, MILLICENT SMOAK (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MILLICENT
Middle Name:SMOAK
Last Name:HEWETT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12884 CLEVELAND ST W
Mailing Address - Street 2:
Mailing Address - City:NAHUNTA
Mailing Address - State:GA
Mailing Address - Zip Code:31553-2834
Mailing Address - Country:US
Mailing Address - Phone:912-816-2160
Mailing Address - Fax:912-816-2160
Practice Address - Street 1:12884 CLEVELAND ST W
Practice Address - Street 2:
Practice Address - City:NAHUNTA
Practice Address - State:GA
Practice Address - Zip Code:31553-2834
Practice Address - Country:US
Practice Address - Phone:912-816-2160
Practice Address - Fax:912-816-2160
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003630235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist