Individual
BRANDY LYNN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
60 S STATE ROUTE 157, EDWARDSVILLE, IL 62025-3846
(000) 000-0000
Mailing address
60 S STATE ROUTE 157, EDWARDSVILLE, IL 62025-3846
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.014623
IL
101YP2500X
Professional Counselor
Primary
180.014158
IL
Other
Enumeration date
11/11/2021
Last updated
04/11/2024
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