Provider Demographics
NPI:1235655762
Name:SMITH, CHASTITY LAMAYA (SLP-A)
Entity Type:Individual
Prefix:
First Name:CHASTITY
Middle Name:LAMAYA
Last Name:SMITH
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 HEARTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-1439
Mailing Address - Country:US
Mailing Address - Phone:225-445-7455
Mailing Address - Fax:
Practice Address - Street 1:1580 HEARTWOOD DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-1439
Practice Address - Country:US
Practice Address - Phone:225-445-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA72422355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant