Individual
MRS. JENNIFER SUSAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
450 SOUTHERN BLVD SE, RIO RANCHO, NM 87124-3206
(505) 994-3305
Mailing address
6909 AUGUSTA HILLS DR NE, RIO RANCHO, NM 87144-8486
(505) 994-3305
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2086
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81738889
—
NM
Enumeration date
02/22/2007
Last updated
07/08/2007
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