Autumn Elizabeth Smith, MS, CCC-SLP
Speech-Language Pathologist, in Chicago, IL. Individual provider (NPI-1).
NPI number1124451877
StatusActive
Last updated in NPPESMay 7, 2020
Details
- NPI
- 1124451877
- Entity type
- Individual (NPI-1)
- Name
- Autumn Elizabeth Smith
- Credential
- MS, CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 16, 2013
- Certification date
- May 7, 2020
- Last updated
- May 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 146012400 | IL | Yes |
| 235Z00000X | Speech-Language Pathologist, | 242002858 | IL |
Practice location
2500 W Bradley Pl Ste 109Chicago, IL 60618-4716
Phone 773-332-9439 · Fax 773-754-8730
Mailing address
2500 W Bradley Pl Ste 109Chicago, IL 60618-4716
Phone 773-332-9439 · Fax 773-754-8730
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