Individual
AMY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
8313 E ALSEA HWY, TIDEWATER, OR 97390-9712
(707) 499-5850
Mailing address
PO BOX 1708, NEWPORT, OR 97365-0126
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
016359
OR
Other
Enumeration date
05/11/2020
Last updated
05/11/2020
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