Individual
MRS. AUDREY LYNNE SMART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., SLP
Contact information
Practice address
4630 JACOB LN, SOUTHAVEN, MS 38672-6732
(662) 893-7321
Mailing address
4630 JACOB LN, 4630 JACOB LN, SOUTHAVEN, MS 38672-6732
(662) 893-7321
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3315
MS
Other
Enumeration date
03/24/2011
Last updated
03/24/2011
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