Individual
TIFFANY NICOLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6918 W WINDSOR AVE, BERWYN, IL 60402-3334
(170) 899-5359
Mailing address
6918 W WINDSOR AVE, BERWYN, IL 60402-3334
(170) 899-5359
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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