Provider Demographics
NPI:1215112107
Name:SMITH, ERIC LAMONT (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:LAMONT
Last Name:SMITH
Suffix:
Gender:M
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 FORREST AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3311
Mailing Address - Country:US
Mailing Address - Phone:302-346-4680
Mailing Address - Fax:302-346-4681
Practice Address - Street 1:1218 FORREST AVE STE 2
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3311
Practice Address - Country:US
Practice Address - Phone:302-346-4680
Practice Address - Fax:302-346-4681
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
DE02-0000038231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty