Individual
DR. JAMES RALPH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2506 GALEN DR, SUITE 103, CHAMPAIGN, IL 61821-7046
(217) 398-0744
(217) 398-0778
Mailing address
2506 GALEN DR, SUITE 103, CHAMPAIGN, IL 61821-7046
(217) 398-0744
(217) 398-0778
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-003744
IL
Other
Enumeration date
08/30/2005
Last updated
09/17/2012
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