Provider Demographics
NPI:1336375070
Name:SMITHWICK, EMILY MARGARET (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARGARET
Last Name:SMITHWICK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:MARGARET
Other - Last Name:PEYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:3007 KNIGHT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2525
Mailing Address - Country:US
Mailing Address - Phone:318-221-8799
Mailing Address - Fax:318-429-0704
Practice Address - Street 1:3007 KNIGHT ST STE 200
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2525
Practice Address - Country:US
Practice Address - Phone:318-221-8799
Practice Address - Fax:318-429-0704
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4884235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist