Individual
DWIGHT SMITH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2525 CONKLIN DR APT 22, ROCKFORD, IL 61101-1871
(779) 210-1136
Mailing address
2525 CONKLIN DR APT 22, ROCKFORD, IL 61101-1871
(847) 306-9843
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/10/2019
Last updated
11/10/2019
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