Individual
MR. KOLIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S. CADC
Contact information
Practice address
2148 VADALABENE DR, MARYVILLE, IL 62062-5632
(618) 288-3100
Mailing address
2148 VADALABENE DR, MARYVILLE, IL 62062-5632
(618) 288-3100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23851
IL
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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