Individual
KATE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 GLEN CROSSING RD, GLEN CARBON, IL 62034-1405
(630) 945-1293
Mailing address
420 N 3RD ST, WOOD RIVER, IL 62095-1718
(479) 223-1778
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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