Individual
KAITLYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
512 PARK DR, BETHALTO, IL 62010-1855
(618) 531-4158
Mailing address
512 PARK DR, BETHALTO, IL 62010-1855
(618) 531-4158
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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