Individual
COREY DANIEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 S MCHENRY AVE, CRYSTAL LAKE, IL 60014-7487
(630) 335-9408
Mailing address
1681 ROCKPORT RD, HAMPSHIRE, IL 60140-9062
(630) 335-9408
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
149.021854
IL
Other
Enumeration date
12/16/2019
Last updated
12/16/2019
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