Provider Demographics
NPI:1629226824
Name:SMITH, ERICA LYNN (AUD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ERICA
Other - Middle Name:LYNN
Other - Last Name:STENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:7301 MISSION RD STE 146
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3005
Mailing Address - Country:US
Mailing Address - Phone:913-384-2105
Mailing Address - Fax:913-384-0735
Practice Address - Street 1:1001 6TH AVE # 105
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-3222
Practice Address - Country:US
Practice Address - Phone:913-682-1870
Practice Address - Fax:913-682-1775
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2158231H00000X
KS1380231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist