Individual
LEVI PATRICK SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5310 E WILLIAM STREET RD, DECATUR, IL 62521-1874
(217) 422-6361
Mailing address
1909 WATERFORD DR., SPRINGFIELD, IL 62703-5771
(217) 416-8774
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
IL
Other
Enumeration date
02/09/2018
Last updated
12/08/2023
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