Provider Demographics
NPI:1669536553
Name:SMOYER, ALANA SUE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:SUE
Last Name:SMOYER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4842 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SLATINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18080-3622
Mailing Address - Country:US
Mailing Address - Phone:610-392-5079
Mailing Address - Fax:
Practice Address - Street 1:4842 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SLATINGTON
Practice Address - State:PA
Practice Address - Zip Code:18080-3622
Practice Address - Country:US
Practice Address - Phone:610-392-5079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006180L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019277790004OtherMEDICAL ASSISTANCE #