Provider Demographics
NPI:1679354062
Name:SMITH, BELINDA LYTHEA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BELINDA
Middle Name:LYTHEA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 GREEN FOREST DR SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-3439
Mailing Address - Country:US
Mailing Address - Phone:770-480-4569
Mailing Address - Fax:
Practice Address - Street 1:813 GREEN FOREST DR SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-3439
Practice Address - Country:US
Practice Address - Phone:770-480-4569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist