Provider Demographics
NPI:1841334877
Name:SMOLIZZA, DEIRDRE THERESA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:THERESA
Last Name:SMOLIZZA
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:DEIRDRE
Other - Middle Name:THERESA
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:283 RIVERCREST DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1064
Mailing Address - Country:US
Mailing Address - Phone:917-647-8915
Mailing Address - Fax:610-933-1125
Practice Address - Street 1:283 RIVERCREST DR
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1064
Practice Address - Country:US
Practice Address - Phone:917-647-8915
Practice Address - Fax:610-933-1125
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010267235Z00000X
PASL010287235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist