Individual
ALEXANDRA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 SPRINGFIELD CT, O FALLON, IL 62269-2495
(217) 525-8332
(217) 789-1420
Mailing address
522 E MAIN ST, MASCOUTAH, IL 62258-2240
(618) 566-0313
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43416
IL
Other
Enumeration date
07/24/2020
Last updated
01/18/2023
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