Individual
MRS. SANDRA KELLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
8057 W DUANE DR, FRANKFORT, IL 60423-8102
(708) 370-9321
Mailing address
8057 W DUANE DR, FRANKFORT, IL 60423-8102
(708) 370-9321
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1583910
IL
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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