Individual
MRS. CHARLENE DEONNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC-A
Contact information
Practice address
107 FRONT STREET, SUITE 2141, VIDALIA, LA 71373
(318) 336-2214
(318) 336-6069
Mailing address
107 FRONT ST, SUITE 2141, VIDALIA, LA 71373-2836
(318) 336-2214
(318) 336-6069
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
4961
LA
237600000X
Audiologist-Hearing Aid Fitter
A2533
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12052628
ASHA
—
01
—
4961
LOUISIANA LICENSE
LA
01
—
A2533
MISSISSIPPI LICENSE
MS
Enumeration date
03/20/2008
Last updated
03/20/2008
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