Provider Demographics
NPI:1922018837
Name:SMITH, DEANNA C (SLP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:C
Last Name:SMITH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 N SALEM ST STE 201
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-1428
Mailing Address - Country:US
Mailing Address - Phone:919-342-5778
Mailing Address - Fax:919-342-4613
Practice Address - Street 1:126 N SALEM ST
Practice Address - Street 2:SUITE 201
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-1428
Practice Address - Country:US
Practice Address - Phone:919-342-5778
Practice Address - Fax:919-342-4613
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6283235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist