Individual
MARYEM SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8200 TODD LN, WATERLOO, IL 62298-5422
(781) 330-9618
Mailing address
8200 TODD LN, WATERLOO, IL 62298-5422
(781) 330-9618
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/21/2018
Last updated
04/21/2018
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