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Individual
LISA CLARK SMITH
Active
Individual
LISA CLARK SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. CCC/SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2264
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SAO659
—
SC
Enumeration date
03/23/2009
Last updated
03/23/2009
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