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Individual

MR. RANDALL WAYNE SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, LCPC, CADC, CS

Contact information

Practice address
601 HIGHWAY 6 W, IOWA CITY, IA 52246-2209
(319) 338-0581
(319) 887-4918
Mailing address
601 HIGHWAY 6 W, IOWA CITY, IA 52246-2209
(319) 338-0581
(319) 887-4918

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180006627
IL
1041C0700X
Clinical Social Worker
Primary
149013021
IL

Other

Enumeration date
04/08/2010
Last updated
04/08/2010
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