Individual
MRS. ANNIE MICHELE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
1770 E LAKE SHORE DR, #209, DECATUR, IL 62521-3832
(217) 423-6500
Mailing address
1770 E. LAKE SHORE DR., #209, DECATUR, IL 62522-3832
(217) 423-6500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.017107
IL
Other
Enumeration date
12/13/2016
Last updated
12/13/2016
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