Provider Demographics
NPI:1427586635
Name:SMITH, MACKENZIE TAYLOR (MS, CF, SLP)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:TAYLOR
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, CF, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 HEMPSTEAD 5
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8904
Mailing Address - Country:US
Mailing Address - Phone:870-397-1850
Mailing Address - Fax:
Practice Address - Street 1:117 E 2ND ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-4402
Practice Address - Country:US
Practice Address - Phone:870-722-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist