Individual
MISS JADIE MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
81 HILLCREST DR, PUNXSUTAWNEY, PA 15767-2605
(724) 349-5070
(724) 349-8368
Mailing address
270 PHILADELPHIA ST, INDIANA, PA 15701-2052
(724) 349-5070
(724) 349-8368
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PSL001347
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PSL001347
PA PROVISIONAL LICENSE
PA
Enumeration date
08/10/2020
Last updated
08/10/2020
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