Individual
DR. FREDERICK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
7425 JANES AVE STE 205, WOODRIDGE, IL 60517-2323
(331) 481-5547
Mailing address
7425 JANES AVE STE 205, WOODRIDGE, IL 60517-2323
(331) 481-5547
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010014
IL
103TC0700X
Clinical Psychologist
PSY004131
GA
Other
Enumeration date
09/27/2017
Last updated
01/31/2023
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