Provider Demographics
NPI:1326285669
Name:SMITH, ELIZABETH DAVIS (MA-SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DAVIS
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 E WOOD ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-3515
Mailing Address - Country:US
Mailing Address - Phone:484-802-2484
Mailing Address - Fax:215-492-1083
Practice Address - Street 1:7051 PASSYUNK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-1724
Practice Address - Country:US
Practice Address - Phone:215-492-1079
Practice Address - Fax:215-492-1083
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist