Provider Demographics
NPI:1588920003
Name:SMITH, LOUISE KILBERT (MS/CCC-SLP)
Entity type:Individual
Prefix:
First Name:LOUISE
Middle Name:KILBERT
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:
Other - First Name:LOUISE
Other - Middle Name:LYNN
Other - Last Name:KILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3161 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-8267
Mailing Address - Country:US
Mailing Address - Phone:724-443-3336
Mailing Address - Fax:
Practice Address - Street 1:3161 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-8267
Practice Address - Country:US
Practice Address - Phone:724-443-3336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL-004487-L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist