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Individual

SAMANTHA SMOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
508 AVONDALE DR, EAST PEORIA, IL 61611-1644
(309) 361-7014
Mailing address
508 AVONDALE DR, EAST PEORIA, IL 61611-1644
(309) 361-7014

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
04/18/2020
Last updated
04/18/2020
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Product
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  • Eligibility checks
  • EDI platform