Individual
MARKEYIA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1931 GROVE AVE APT B2, BERWYN, IL 60402-1760
(773) 981-1413
Mailing address
1931 S. GROVE AVE. B2, BERWYN, IL 60402
(773) 981-1413
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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