Individual
LISA SUZANNE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 W PIONEER PKWY STE 6, PEORIA, IL 61615-1883
(309) 253-2471
Mailing address
2000 W PIONEER PKWY STE 6, PEORIA, IL 61615-1883
(309) 253-2471
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.020516
IL
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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