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Individual

ETHAN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
535 ELM PL STE 7, PRINCETON, IL 61356-1458
(815) 872-2943
(815) 915-8756
Mailing address
535 ELM PL STE 7, PRINCETON, IL 61356-1458
(815) 872-2943
(815) 915-8756

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178016281
IL

Other

Enumeration date
05/19/2021
Last updated
05/19/2021
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