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Individual

MRS. SHARON E SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
2367 GA HIGHWAY 88, HEPHZIBAH, GA 30815-4630
(706) 592-5565
(706) 751-0825
Mailing address
2 SHADOWMOOR CT, NORTH AUGUSTA, SC 29841-6016
(803) 278-2826
(803) 278-2826

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004570
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000877753C
GA
01
10040561
AMERIGROUP
GA
01
308505
WELLCARE
GA
Enumeration date
12/28/2006
Last updated
04/14/2009
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