Individual
COLIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Mailing address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/08/2009
Last updated
10/08/2009
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