Individual
TRICIA MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 W ELLSWORTH ST, COLUMBIA CITY, IN 46725-2302
(260) 248-8101
Mailing address
2421 N ANTHONY BLVD, FORT WAYNE, IN 46805-3603
(260) 413-5445
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003199A
IN
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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