Provider Demographics
NPI:1578835336
Name:SMATHERS, MOLLY S (CCC/SLP-L)
Entity Type:Individual
Prefix:MISS
First Name:MOLLY
Middle Name:S
Last Name:SMATHERS
Suffix:
Gender:F
Credentials:CCC/SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 E JAMESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-9206
Mailing Address - Country:US
Mailing Address - Phone:724-588-7613
Mailing Address - Fax:
Practice Address - Street 1:339 E JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-9206
Practice Address - Country:US
Practice Address - Phone:724-588-7613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist