Individual
MS. LATEENA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDS
Contact information
Practice address
682 W BOUGHTON RD, BOLINGBROOK, IL 60440-5700
(630) 398-6204
Mailing address
605 PICCADILLY LN, BOLINGBROOK, IL 60440-1021
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2384168
IL
Other
Enumeration date
07/05/2017
Last updated
07/05/2017
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