Individual
DAVID WAYNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
10010 KENNERLY RD, SAINT LOUIS, MO 63128-2106
(314) 525-1000
Mailing address
107 ROGER DR, COLLINSVILLE, IL 62234-5814
(618) 792-1482
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2008035911
MO
1041C0700X
Clinical Social Worker
Primary
149.004794
IL
Other
Enumeration date
01/04/2011
Last updated
11/14/2019
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