Provider Demographics
NPI:1386870301
Name:SMITH, NATALIE LAUREN (MA CCC SLP- TSHH)
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:LAUREN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA CCC SLP- TSHH
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Mailing Address - Street 1:3333 HENRY HUDSON PKWY
Mailing Address - Street 2:5C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3224
Mailing Address - Country:US
Mailing Address - Phone:917-499-0569
Mailing Address - Fax:
Practice Address - Street 1:4300 HYLAN BLVD LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6505
Practice Address - Country:US
Practice Address - Phone:718-984-9022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY017901-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist