Individual
TIFFANY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 BUCHANAN ST, MENTAL HEALTH CENTERS OF WESTERN ILLINOIS, CARTHAGE, IL 62321
(217) 357-3176
(217) 357-6609
Mailing address
711 ECR 1720, NAUVOO, IL 62354
(217) 357-3176
(217) 357-6609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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