Provider Demographics
NPI:1396178661
Name:SMITH, NADINE MARIE (MS,CCC)
Entity Type:Individual
Prefix:MS
First Name:NADINE
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS,CCC
Other - Prefix:MS
Other - First Name:NADINE
Other - Middle Name:MARIE
Other - Last Name:PLOEDERL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC
Mailing Address - Street 1:9433 BEE CAVE RD
Mailing Address - Street 2:BUILDING 3 SUITE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-6135
Mailing Address - Country:US
Mailing Address - Phone:512-306-8887
Mailing Address - Fax:
Practice Address - Street 1:9433 BEE CAVE RD
Practice Address - Street 2:BUILDING 3 SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78733-6135
Practice Address - Country:US
Practice Address - Phone:512-306-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108389235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist