Individual
MARY L. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 UNIVERSITY CIRCLE, WESTERN IL UNIV, CNTR FOR BEST PRACTICES IN EARLY CHILDHOOD EDUCATION, MACOMB, IL 61455
(800) 701-0995
(309) 298-3066
Mailing address
518 S EAST AVE, OAK PARK, IL 60304-1322
(708) 848-8514
(708) 848-8514
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
06/19/2009
Last updated
06/19/2009
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