Individual
DONTAEVEZ SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1208 W JEFFERSON ST APT F, SPRINGFIELD, IL 62702-6411
(217) 953-5038
Mailing address
1208 W JEFFERSON ST APT F, SPRINGFIELD, IL 62702-6411
(217) 953-5038
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/29/2025
Last updated
12/29/2025
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