Provider Demographics
NPI:1811265531
Name:SMITH, JACQUELINE ALANNA (AUD)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:ALANNA
Last Name:SMITH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 PLAZA DR STE 110
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2348
Mailing Address - Country:US
Mailing Address - Phone:720-627-6378
Mailing Address - Fax:844-368-6588
Practice Address - Street 1:1399 S HAVANA ST
Practice Address - Street 2:SUITE 102
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4020
Practice Address - Country:US
Practice Address - Phone:303-337-9699
Practice Address - Fax:303-337-9546
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO640231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist