Organization
ROLANDA M SMITH
Active
Other names
R A W Professional Services
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ROLANDA M SMITH (DEVELOPMENTAL THERAPIST)
(708) 201-0058
Entity
Organization
Contact information
Practice address
430 E 162ND ST STE 430, SOUTH HOLLAND, IL 60473-2258
(708) 201-0058
(888) 646-5822
Mailing address
430 E 162ND ST STE 430, SOUTH HOLLAND, IL 60473-2258
(708) 201-0058
(888) 646-5822
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000444156276201
—
IL
Enumeration date
10/15/2007
Last updated
08/05/2011
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