Provider Demographics
NPI:1467647032
Name:SMITH, DOLORES INEZ (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:INEZ
Last Name:SMITH
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:DOLORES
Other - Middle Name:INEZ
Other - Last Name:AYALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:
Mailing Address - City:TOMBSTONE
Mailing Address - State:AZ
Mailing Address - Zip Code:85638
Mailing Address - Country:US
Mailing Address - Phone:520-457-2217
Mailing Address - Fax:520-457-3270
Practice Address - Street 1:100 SCHOOL DR
Practice Address - Street 2:
Practice Address - City:HUACHUCA CITY
Practice Address - State:AZ
Practice Address - Zip Code:85638
Practice Address - Country:US
Practice Address - Phone:520-456-9842
Practice Address - Fax:520-456-9811
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant