Provider Demographics
NPI:1780008276
Name:SMOCK, NANCY F (CCC/SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:F
Last Name:SMOCK
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-1514
Mailing Address - Country:US
Mailing Address - Phone:339-201-7959
Mailing Address - Fax:
Practice Address - Street 1:574 MAIN STREET
Practice Address - Street 2:FIRST EI PROGRAM
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190
Practice Address - Country:US
Practice Address - Phone:781-331-2533
Practice Address - Fax:781-340-1337
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1875-W235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist