Individual
MS. VIRGINIA LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
780 GUARDSMAN WAY, SALT LAKE CITY, UT 84108-1374
(801) 581-0194
Mailing address
780 GUARDSMAN WAY, SALT LAKE CITY, UT 84108-1374
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2941584102
UT
235Z00000X
Speech-Language Pathologist
6412
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29415841000001
BLUE CROSS
UT
Enumeration date
01/23/2006
Last updated
07/08/2007
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