Provider Demographics
NPI:1558052076
Name:SMITH, LAUREL ELIZABETH (AUD)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 CONCORD ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2269
Mailing Address - Country:US
Mailing Address - Phone:330-685-3263
Mailing Address - Fax:
Practice Address - Street 1:4912 HIGBEE AVE NW STE 200
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2599
Practice Address - Country:US
Practice Address - Phone:330-492-2844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02438231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist