Individual
BRANDY S SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
136 PREMIER LN, CARBONDALE, IL 62902-4101
(715) 577-8764
Mailing address
500 SALUKI BLVD APT 1022C, CARBONDALE, IL 62903-8236
(217) 663-5868
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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