Provider Demographics
NPI:1710634936
Name:SMITH, MADISON JEAN (MS)
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:JEAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:MADISON
Other - Middle Name:JEAN
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:GRANTHAM
Mailing Address - State:PA
Mailing Address - Zip Code:17027-0292
Mailing Address - Country:US
Mailing Address - Phone:570-971-6520
Mailing Address - Fax:
Practice Address - Street 1:770 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4105
Practice Address - Country:US
Practice Address - Phone:717-249-1363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist