Provider Demographics
NPI:1952560757
Name:SMITH, GERALDINE JONES (PHD/CCC)
Entity Type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:JONES
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 BLUEBONNET BLVD APT 707S
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1675
Mailing Address - Country:US
Mailing Address - Phone:504-232-8021
Mailing Address - Fax:225-977-1780
Practice Address - Street 1:7410 BLUEBONNET BLVD APT 707S
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1675
Practice Address - Country:US
Practice Address - Phone:504-232-8021
Practice Address - Fax:225-977-1780
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist