Provider Demographics
NPI:1639738537
Name:PAMELA E SMITH THERAPIES, INC.
Entity Type:Organization
Organization Name:PAMELA E SMITH THERAPIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:321-536-6761
Mailing Address - Street 1:3235 SE RIVER VISTA DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5928
Mailing Address - Country:US
Mailing Address - Phone:321-536-6761
Mailing Address - Fax:772-408-0197
Practice Address - Street 1:3235 SE RIVER VISTA DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5928
Practice Address - Country:US
Practice Address - Phone:321-536-6761
Practice Address - Fax:772-408-0197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty