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Individual
MR. RICKY BRIAN SMITH
Active
Individual
MR. RICKY BRIAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
208.000749
IL
106H00000X
Marriage & Family Therapist
Primary
166001501
IL
Other
Enumeration date
10/01/2019
Last updated
10/04/2021
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