Individual
MS. LARISSA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
930 GREEN BAY RD, UNIT C, GLENCOE, IL 60022-1286
(847) 242-9567
Mailing address
930 GREEN BAY RD, UNIT C, GLENCOE, IL 60022-1286
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
03/01/2008
Last updated
03/01/2008
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