Organization
SMITH INTERACTIVE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER S SMITH M.A., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(505) 228-4522
Entity
Organization
Contact information
Practice address
6909 AUGUSTA HILLS DR NE, RIO RANCHO, NM 87144-8486
(505) 228-4522
Mailing address
6909 AUGUSTA HILLS DR NE, RIO RANCHO, NM 87144-8486
(505) 228-4522
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336274133
—
NM
Enumeration date
10/14/2019
Last updated
10/19/2019
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