Most Relevant Information
Provider Data
| NPI Number: | 1003309154 |
| Provider Name: | MICAH JOEL SMITH |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 200127 |
Most Important Dates
| Enumeration Date: | 06/13/2018 |
| Last Updated: | 06/13/2018 |
Provider Practice Location
3801 JOHNSON MILL BLVD # AB
FAYETTEVILLE
AR
727045297
Practice Location Phone/Fax
| Phone: | 4797900684 |
| Fax: |
Provider Mailing Location
327 S UNIVERSITY AVE APT 4
FAYETTEVILLE
AR
727015861
Provider Mailing Phone/Fax
| Phone: | 4797900684 |
| Fax: |