Individual
OLIVIA L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
12075 CORPORATE PKWY STE 110, MEQUON, WI 53092-2664
(877) 486-4140
(847) 486-4145
Mailing address
950 LEE ST, SUITE 210, DES PLAINES, IL 60016-6532
(877) 486-4140
(847) 486-4145
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19887
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129-140
STATE OF WISCONSIN
WI
Enumeration date
01/06/2016
Last updated
01/09/2018
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