Individual
ALEXANDER BLAKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
507 E ARMSTRONG AVE, PEORIA, IL 61603-3201
(300) 968-6117
Mailing address
507 E ARMSTRONG AVE, PEORIA, IL 61603-3201
(309) 686-1177
(309) 686-7722
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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