Provider Demographics
NPI:1427339142
Name:SMILEY, DAISY BOSQUE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DAISY
Middle Name:BOSQUE
Last Name:SMILEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 MONTICELLO DR
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8715
Mailing Address - Country:US
Mailing Address - Phone:808-255-4178
Mailing Address - Fax:
Practice Address - Street 1:1470 MONTICELLO DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8715
Practice Address - Country:US
Practice Address - Phone:808-255-4178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11706235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist