Provider Demographics
NPI:1538314968
Name:SMITH, ANNE CHRISTA (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:CHRISTA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PINEGROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554
Mailing Address - Country:US
Mailing Address - Phone:413-687-1217
Mailing Address - Fax:
Practice Address - Street 1:83 PEARL STREET
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3937
Practice Address - Country:US
Practice Address - Phone:508-775-6240
Practice Address - Fax:508-790-4298
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA398153235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist