Provider Demographics
NPI:1285380592
Name:SMILEY PEDIATRIC SPEECH THERAPY LLC
Entity type:Organization
Organization Name:SMILEY PEDIATRIC SPEECH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:L
Authorized Official - Last Name:TONER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:443-422-2658
Mailing Address - Street 1:224 PHILLIP MORRIS DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1964
Mailing Address - Country:US
Mailing Address - Phone:443-422-2658
Mailing Address - Fax:
Practice Address - Street 1:224 PHILLIP MORRIS DR STE 202
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1964
Practice Address - Country:US
Practice Address - Phone:443-422-2658
Practice Address - Fax:443-498-2802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine