Constance Cheryl Smith, M.S., M.ED.

Individual provider Active NPI Speech-Language Pathologist · New Alany, IN

NPI 1902035355 · NPPES record last updated Jul 8, 2009

Key facts

NPI
1902035355
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
0100-9441 (IN)
Practice address
3101 Azalea Drive
New Alany, IN 47150
Phone
(812) 949-1518
Fax
(812) 949-1518
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education, Master of Science

State licenses

LicenseStateTypeSpecialty
0100-9441INMDSpeech-Language Pathologist
01009441INMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 01009441 IN
Speech-Language Pathologist 235Z00000X 0100-9441 IN Yes

Addresses

Primary practice location

3101 Azalea Drive
New Alany, IN 47150

Mailing address

3101 Azalea Drive
New Albany, IN 47150

Sources for this page

Verify at the official NPI Registry.