Christopher Lee Smith, | |
1651 E Nickerson Ave, Benton Harbor, MI 49022-2469 | |
(269) 876-5697 | |
Not Available |
Full Name | Christopher Lee Smith |
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Gender | Male |
Speciality | Speech-language Pathologist |
Location | 1651 E Nickerson Ave, Benton Harbor, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427835826 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 7101008338 (Michigan) | Primary |
Provider Name | Logan Community Resources Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1891917449 PECOS PAC ID: 2961790126 Enrollment ID: O20161004002087 |
Mailing Address | Practice Location Address |
---|---|
Christopher Lee Smith, 1651 E Nickerson Ave, Benton Harbor, MI 49022-2469 Ph: (269) 876-5697 | Christopher Lee Smith, 1651 E Nickerson Ave, Benton Harbor, MI 49022-2469 Ph: (269) 876-5697 |
Kinsey Harrison, MS, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-983-5833 | |
Jessica Gaytan, MS SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-876-5697 | |
Jacqueline Schmitt, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-983-5833 | |
Anna Patricia Livingston, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-983-5833 | |
Rachelle Dodge, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-876-5697 Fax: 269-359-3730 | |
Kathryn Vandermolen, Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 1651 E Nickerson Ave, Benton Harbor, MI 49022 Phone: 269-983-5833 Fax: 269-363-4630 |