Provider Demographics
NPI:1184859886
Name:SMITH, JOANNE F (MSCCCSLP)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:F
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:MS
Other - First Name:JOANNE
Other - Middle Name:F
Other - Last Name:SMITHPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSCCCSLP
Mailing Address - Street 1:55 TROPIC ISLE DR.
Mailing Address - Street 2:#36
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483
Mailing Address - Country:US
Mailing Address - Phone:561-350-1503
Mailing Address - Fax:561-278-9401
Practice Address - Street 1:55 TROPIC ISLE DR.
Practice Address - Street 2:#36
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483
Practice Address - Country:US
Practice Address - Phone:561-350-1503
Practice Address - Fax:561-278-9401
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist