Provider Demographics
NPI:1306126313
Name:SMITH, CARRIE M (AUD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 JOHN EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:MOSELLE
Mailing Address - State:MS
Mailing Address - Zip Code:39459-9771
Mailing Address - Country:US
Mailing Address - Phone:601-475-9304
Mailing Address - Fax:
Practice Address - Street 1:3 JOHN EVERETT RD
Practice Address - Street 2:
Practice Address - City:MOSELLE
Practice Address - State:MS
Practice Address - Zip Code:39459-9771
Practice Address - Country:US
Practice Address - Phone:601-475-9304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA3610231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist