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Individual

DOUG C SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
819 BLOOMINGTON RD, CHAMPAIGN, IL 61820-2101
(217) 356-1558
Mailing address
206 CATTAIL, SAVOY, IL 61874-9498
(217) 419-6260

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149014719
IL

Other

Enumeration date
02/20/2020
Last updated
02/20/2020
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