Individual
GINA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
9405 BORMET DR STE 6, MOKENA, IL 60448-7400
(708) 290-9020
Mailing address
9405 BORMET DR STE 6, MOKENA, IL 60448-7400
(708) 290-9020
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
06/28/2017
Last updated
04/05/2024
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