Provider Demographics
NPI:1588413025
Name:FROST-SMITH, LOUISA R (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:LOUISA
Middle Name:R
Last Name:FROST-SMITH
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CUNAT BLVD APT 1A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IL
Mailing Address - Zip Code:60071-8909
Mailing Address - Country:US
Mailing Address - Phone:815-307-5958
Mailing Address - Fax:
Practice Address - Street 1:146 CLOVER ST
Practice Address - Street 2:
Practice Address - City:WILLIAMS BAY
Practice Address - State:WI
Practice Address - Zip Code:53191-9779
Practice Address - Country:US
Practice Address - Phone:262-245-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIPENDING235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist