Beverly B Smith, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Arlington, GA
NPI 1104965367 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104965367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP000774 (GA)
- Practice address
- RR 2 Box 205
Arlington, GA 39813-9643 - Phone
- (229) 725-3270
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP000774 | GA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP000774 | GA | Yes |
Addresses
Primary practice location
RR 2 Box 205
Arlington, GA 39813-9643
Mailing address
RR 2 Box 205
Arlington, GA 39813-9643
Phone (229) 725-3270
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All providers in Arlington, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.